Psychosocial risk factors and processes impeding adaptive capacities and contributing to psychosocial distress among later-life Egyptian immigrants

ABSTRACT

This qualitative study explores and describes the transactional and cumulative psychosocial stressors that later-life Egyptian immigrants encounter upon coming to the United States, and how they impede their adaptive capacities, hinder their adjustment efforts, and impact their psychosocial well-being. Such stressors are more pronounced among those who immigrated to the United States from Egypt after reaching the retirement age of 60 for two reasons. First, they experience pre-immigration stressors that force or expedite their departure from Egypt under duress, thus incurring numerous financial and symbolic losses. Secondly, in the last developmental stage, when age-related losses are triggered, they are concomitantly exposed to a starkly different lifestyle, language, cultural norms, living and financial arrangements, roles, and relationships. All such circumstances contribute to a sense of confusion, guilt, shame, and being a burden on others, which culminate in withdrawal, isolation, and distress. The findings of this study can be used to inform psychosocial and therapeutic interventions and guide the development of appropriate social work programs, services, and policies for later-life Egyptian immigrants in particular and older Arabic-speaking immigrants in general.     

Pathways to age-friendly communities in diverse urban neighborhoods: Do social capital and social cohesion matter?

ABSTRACT

Using a social capital and social cohesion lens, we reposition the concept of civic engagement among older adults to examine pathways for building age-friendly communities. We analyzed data drawn from a Community-Based Participatory Research study in the Southern U.S. that explored lived experiences of older adults, age 55 and above, who participated in individual interviews (n = 15) and six focus group discussions (n = 45) to examine their perceptions of social identity, social connectedness, and civic engagement geared toward an age-friendly city. Findings indicated that several older adults had access to social networks and socially invested resources, thereby having opportunities for civic engagement and building age-friendly neighborhoods. However, social, cultural, linguistic, and structural barriers were more evident among certain diverse ethnic populations. Marginalized low-income minorities and immigrants, such as Hispanic participants, felt the lack of social cohesion among the larger society limited their ability to give back, thus decreasing their civic engagement activities. In contrast, Caucasian and African-American older adults were able to contribute to the political process through more civic participation activities. We provide implications for examining the role of social capital and social engagement to bolster civic engagement among older adults in building age-friendly communities.     

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.     

Hardly Silent: Exploring Civic Engagement and Participation among a Panel of Adults Ages 85+

ABSTRACT

The past twenty years have seen a surge of resources for and public attention devoted to civic participation opportunities for older adults in the United States. At the same time, technology has transformed the way information related to political and social issues is spread and shared. As more older adults migrate to using a wider range of communication tools and the internet, technology-mediated forms of engagement represent a new way for the oldest old to participate in society. In this study, a panel of adults ages 85 and older was surveyed to understand their experiences engaging with political and social issues. Responses to a questionnaire (N = 24) and focus groups (n = 22) indicate the oldest old are interested in social and political issues, and there are opportunities for technology to facilitate the oldest olds’ civic and political action. This study identifies roles social workers may play in helping the oldest old engage with social and political issues in their communities.     

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.     

The Impact of Religiousness,Spirituality, and Social Support on Psychological Well-Being Among Older Adults in Rural Areas

Summary

This paper presents the results of a study on the impact of spirituality, religiousness, and social support on the psychological well-being among rural elderly. With a rural community sample of 215 older adults, hierarchical regression analyses found significant associations between dimensions of spirituality/religiousness, social support, and psychological well-being, with spirituality/religiousness inversely related to depression and social support, positively related to life satisfaction. Findings of this study suggest that practitioners need to develop programs or services that are congruent with religious/spiritual beliefs and practices in order to better enhance the psychosocial well-being and improve the quality of life among older persons in rural areas.     

The Self-Forgiveness Process of Caregivers After the Death of Care-Receivers Diagnosed With Alzheimer's Disease

ABSTRACT

This study explores the relationship of self-forgiveness and adaptive coping, religious/spiritual practices, social support, decreased grief, and mental well-being. 133 caregivers were surveyed. Bivariate analysis and stepwise regression models revealed that decreased grief, adaptive coping, and social support were significant in explaining the variation in self-forgiveness. This is one of the first studies to address self-forgiveness as part of the grieving process of Alzheimer's caregivers. Future directions are explored supporting inclusion of self-forgiveness as an aspect of grief and adaptive coping; which is further enhanced by the level of social support experienced by the caregiver.     

Resident-Managed Elder Intentional Neighborhoods: Do They Promote Social Resources for Older Adults?

Social isolation has serious negative public health impacts for older adults. Survey data were collected at three resident-managed elder intentional neighborhoods in the United States (n = 59), to determine if these neighborhoods, each based on the cohousing model, promote development of social resources for their residents. Social resources were measured on three dimensions: social networks, neighborly support, and satisfaction with the neighborhood community. Respondents were White, mean age of 73.3 (range = 63–91), primarily female (76.3%), and generally had high levels of education and self-reported health. Almost half (47%) were never married/divorced and 37% were childless. Inclusion of neighborhood ties ameliorated risk of social isolation. Satisfaction with support and a variety of neighboring behaviors were reported. These neighborhoods are meeting the needs of a potentially at-risk population as an avenue to promote social resources and reduce social isolation. The implications for gerontological social workers include a role in helping to mobilize and support these types of neighborhoods as a way to encourage mutual support among older adults. With the increase in the aging population, such models of proactive interdependence and communal coping have the potential to lessen or delay the demands that socially isolated elders place on social workers.     

Financial Capability,Asset Ownership,and Later-Age Immigration: Evidence From a Sample of Low-Income Older Asian Immigrants

We examined financial capability and asset ownership among low-income older Asian immigrants with special attention given to later-age immigrants who came to the United States when they were 55 years old or older. Survey data collected from supported employment program participants (N = 150) were used. The analyses demonstrated a low level of financial knowledge and asset ownership in the sample. The findings also indicated that later-age immigrants’ financial-management skills, knowledge of social programs, and asset ownership were significantly lower than those of young-age immigrants. These findings call for active interventions to enhance economic security among low-income older Asian immigrants.     

Family and community support among older Chilean adults: the importance of heterogeneous social support sources for quality of life

Family and community social networks act as social resources that promote well-being at advanced ages. In this study, we analyze the association between social support received from personal social networks (social support from various family members and friends) and community social networks (social support from neighbors and the neighborhood, age, ethnic, or religious group peers and formal social support networks) and quality of life (QoL) for a sample of older Chilean persons (n = 777). The results confirm that social support from family (partner, children, and extended family) and friends, integration in the community (neighbors) and social support from informal systems (social groups) are associated with QoL. Moreover, the model including both types of support explains 25.8% of variance in QoL. The results and their possible implications are discussed.     

Validation of multidimensional scale of perceived social support in middle-aged Korean women with diabetes

Purpose: The purpose of this study was to validate the Multidimensional Scale of Perceived Social Support (MSPSS) among middle-aged Korean women with type 2 diabetes. Methods: Data were collected from 123 middle-aged Korean women with diabetes. Construct and concurrent validity were examined using factor analysis. Results: Factor analysis extracted three factors: spouse, family, and friends. The MSPSS had relatively good concurrent validity (r = .66, p < .0001), construct validity, and strong reliability (Cronbach's alpha = .90). Conclusion: We concluded that the MSPSS is a simple and well-established instrument to measure social support in middle-aged Korean women with diabetes.     

Functional Independence of Community-Dwelling Older Adults in China and South Korea

ABSTRACT

Population aging is occurring at an unprecedented pace in China and South Korea. This study intended to identify and compare factors associated with older adults’ functional status in China and South Korea using data from 2 national surveys. The study sample consisted of adults aged 65 to 79 years old drawn from the Chinese Longitudinal Healthy Longevity Survey (2005; n = 4,898) and the Korean Longitudinal Study on Aging (2006; n = 4,152). The outcome variable, functional status, was defined as dependence in self-care tasks. Stepwise multiple regression analysis was used to assess the explanatory contributions of sociodemographics, health conditions, and health behaviors and activities to functional status. These Asian older adults shared certain commonalities in maintaining functional independence in their communities, and absence of diseases and higher cognition were associated with functional independence in both countries. Rural residence and outdoor activity were significant for Chinese older adults; for their South Korean peers, gender, employment status, drinking, and exercise were important. This study adds to a slowly growing body of knowledge of ways to improve the functional independence of community-dwelling older persons in these 2 Asian countries and beyond. More research is needed to identify cross-cultural and/or cross-country differences.     

Exploratory Study on Challenges Faced by Ageing Persons with Physical Disabilities

With a longer life expectancy, adults with lifelong physical disabilities face a double challenge of experiencing physical ravages brought on by normal ageing in addition to a deterioration of their pre-existing disabilities. This exploratory study seeks to uncover whether older adults with lifelong physical disabilities are buffered with sufficient financial, familial, social, and spiritual resources to deal with this double challenge. More dialogue should be initiated to prepare vulnerable older adults with lifelong physical disabilities for their old age before they are swept away by the tsunami of unexpected problems resulting in them needing more social support in their old age.     

Assessment of multiple constructs of social integration for older adults living in nursing homes

ABSTRACT

A variety of terms and measures have been used in the literature to denote being socially integrated, and many studies of older adults focus on only social networks or social support and often only include those living in the community. The purpose of this study was to assess multiple constructs of social integration (i.e., social networks, social capital, social support, and social engagement) for older adults in nursing homes. Data were collected from 140 older adults at 30 nursing homes in Kansas. We interviewed older adults’ in-person using a survey questionnaire, and used multilevel confirmatory factor analysis to analyze the data. The final model that included the four constructs had acceptable fit (χ² = 174.71; df = 112; p < .01; CFI = .93; RMSEA = .06; SRMR-W = .06; SRMR-B = .12). The results showed that the proposed model was supported at the individual level. At the between-level, social networks and social support were supported. Study results have methodological and practice/policy implications for the study of older adults in long term care settings. In particular, this study contributes to understanding how to operationally define and differentiate social integration variables in studies of older adults, particularly when study data are hierarchical.     

“Working with COW”: Social Work Supporting Older Women Living in the Community

ABSTRACT

Australia, like all developed Western countries, is experiencing a demographic shift resulting in an increasing proportion of the population being over the age of 65 years. Contrary to stereotypes, the vast majority of older people live independently in communities. This article explores the potential of social work practice informed by community development principles to enable socially disadvantaged older women to live in vibrant and supportive communities, in which they feel safe and are able to access the support services they need. It argues that participation in social action not only builds older women’s well-being but also enables them to become (or continue to be) agents for social change in local communities. Adopting a community-based research methodology, this article draws on a decade of community development practice with the Concerned Older Women’s (COW) Group. This data suggests that community development practice based on participation, empowerment, and social action founded on respectful relationships may accrue significant benefits to individuals and the broader community. This social work practice creates the social conditions to facilitate older women’s capacity to work collectively to achieve social change, challenging ageist stereotypes.     

The impact of religiousness, spirituality, and social support on psychological well-being among older adults in rural areas

This paper presents the results of a study on the impact of spirituality, religiousness, and social support on the psychological well-being among rural elderly. With a rural community sample of 215 older adults, hierarchical regression analyses found significant associations between dimensions of spirituality/religiousness, social support, and psychological well-being, with spirituality/religiousness inversely related to depression and social support, positively related to life satisfaction. Findings of this study suggest that practitioners need to develop programs or services that are congruent with religious/spiritual beliefs and practices in order to better enhance the psychosocial well-being and improve the quality of life among older persons in rural areas.     

A Pastoral Understanding of Positive Aging

Abstract

Positive aging may be more dependent on spiritual well-being than physical capacity. Understanding the spiritual perspective derives from the dichotomy between the “perceptual” and the “spiritual” realms of human awareness. Awareness of spiritual process in relationship to positive aging may also offer counseling additional challenges and opportunities, including: a balanced perspective on life issues, a sense of humor, counter-factual thinking, internal strengths and resources for growing through life losses and crises, and compensation skills that focus on current capacity and chosen pathways rather than dwelling on lost abilities.     

Spirituality in Social Work Groups: Practitioners Speak Out

ABSTRACT

The attitudes of experienced clinicians regarding the inclusion of spirituality in social group work practice and education are examined. Using a focus group format, practitioners concurred that wholistic treatment of clients must embody spiritual issues and that spiritual content should be covered in group work courses. Clinicians identified additional issues including: (a) need for spiritual assessment; (b) necessity of practitioner self-awareness; (c) usefulness of spiritual beliefs and communities as resources; (d) creation of a safe environment; (e) promotion of spiritual diversity in groups; and (f) collaboration with clergy and spiritual leaders. Implications for practice, research, and education are discussed.