农村丧偶老年人的家庭养老境遇——基于山东省三乡镇210名农村老年人的调查

通过对山东省三乡镇的210名农村老年人进行调查,对农村老年人的养老现状有了更清晰的认识:农村老年人丧偶后开始正式获得子女提供的经济供养;丧偶老年人主要的经济来源是其子女提供的经济供养,但获得子女的生活照料和精神慰藉却很少;在失去配偶的照料和精神慰藉的同时,丧偶老年人的家庭角色逐渐边缘化。传统家庭养老模式对丧偶老年人养老的承载能力止于物质层面,丧偶老年人生活、精神层面的养老需求亟待多元化养老主体的供给。     

昆明市空巢老人健康与照顾需求的评估

“空巢”是中国科技与社会发展、独生子女政策落实的必然。日益增长的“空巢老人”为国家福利、代际和谐和社区照顾带来了严峻挑战。本文从社会保障的视角,采用健康自测量表（SRHMS）,从生理、心理和社会健康的维度,对昆明市10所养老机构和18个社区的289位空巢老人和212名非空巢老人进行了比较分析,发现空巢老人社会健康与心理支持令人担忧。文章就构建“空巢老人”长期照顾网络作了讨论和建议。     

Informal Support Networks Meet Health needs of Rural Elderly

While major studies of informal support systems have been conducted in urban areas, it is important to gain comparable knowledge for the rural and small town communities in which so many older people live. This exploratory study had as its overall purpose to examine the association between community based informal support networks and the ability of older adults to carry out daily activities in a rural area-the measure of the functional health status of the person. Within a rural perspective the outcome of the study included: replication of urban data in terms of network identification; the generation for further study of two hypotheses related to the association of network functionality and functional health and one hypothesis related to the association of network proximity and functionality; and recommendations of unstudied areas of concern for a better understanding of network functionality.     

Family Caregivers of the Elderly

Two groups of primary family caregivers were interviewed; one whose older relatives received assistance from an inhome chore services program, the other whose relatives had been terminated from service due to budget reductions. Both groups of caregivers were found to be actively involved in providing care to their older relatives. The assistance that caregivers provided was similar whether or not their relative received chore services. No significant differences were found in the type of tasks they provided nor in the amount or length of time they have provided care. The data suggest that there may be limits to the assistance that these caregivers can provide and that care of the elderly beyond such limitations needs to be supplied by other sources. Caregiving may be influenced both by the particular circumstances of the caregiver and the individual needs of the older relative. These findings support the notion that there is a need for shared responsibility between the family and government, based on an understanding of the tasks that family caregivers are best able to provide.     

Cultural and Intergenerational Narratives: Understanding Responses to Elderly Family Members in Declining Health

Culture exerts powerful influences on each generations' responses to older members in declining health. Narratives, the stories people tell about their lives, depict the different the ways that the elderly and their children experience their world. Their personal narratives chronicle their connections to culture the past. They also illustrate the ways that the cultural values are transformed to accommodate the present and future. The stories are influenced by immigration, assimilation, development, interpersonal relationships, and life events. These differences between the cultural narratives of the elderly and the following generation are particularly apparent during times of chronic stress. One such situation occurs during chronic illness when the younger generation is called upon to provide for the elderly and chronically ill.     

家庭照料对城乡失能老人和照料者健康的影响

基于2018年中国健康与养老追踪调查数据,使用递归双变量probit模型研究家庭照料对城乡失能老人及其照料者健康的影响.研究发现,家庭照料能显著改善失能老人的身体和心理健康状况,但不利于照料者的身体和心理健康.家庭照料使城镇失能老人身体健康的概率增加42.8％、 抑郁的概率降低45.6％;使农村失能老人抑郁的概率降低38.3％,但对其身体健康没有显著影响.家庭照料使农村照料者身体健康的概率降低18.8％、 抑郁的概率增加49.4％;使城镇照料者抑郁的概率增加41.7％,但对其身体健康没有显著影响.应加强长期护理保险对社会照料尤其是居家照料服务的支持,并以此减轻家庭照料者负担、 提升家庭照料效果.     

Living Arrangements,Depression, and Health Status Among Elderly Russian-Speaking Immigrants

Abstract

This study examines the relationship between living arrangements, depression, and health status in a community-based sample of 300 elderly Russian-speaking immigrants. Data were collected via a self-administered questionnaire survey method. The questionnaire was designed to investigate various aspects of health, mental health, health services utilization, and health behaviors. A team of bilingual professionals was involved in the construction and translation of the survey instrument. The sample consists of 150 females and 150 males. The respondents' average age was 73.2 years. The regression analysis reveals that elderly Russian-speaking immigrants who live alone are more likely to experience a higher level of depression than those living with others. This relationship remains statistically significant after controlling for age, education, income, ability to speak English, years residing in the United States, gender, and health status. Since health status appears to influence depression, we performed further regression analyses and found that living arrangements had no statistically significant relationship with health status. Health status serves as an intermediate variable between the block of demographic variables and depression. Implications for future research are discussed.     

Measuring Family Caregiver Perceptions of Support in Caring for Children and Youth With Mental Health Concerns

ABSTRACT

This correlational study assessed how families of children with mental illness perceived the levels of support they received from informal and formal resource providers and the associations between perceived support and child outcomes. Adult caregivers (N = 904) of youth receiving public mental health care services were administered the Family Caregiver Perceptions of Support Scale developed by the authors to assess family caregiver perceptions of support prior to and at termination of services. Factor analysis identified three types of caregiver anticipated supports: informal support resources, support for treatment plan influence, and health care resources. The domains were significantly and positively associated with one another but did not uniformly correlate with youth mental health outcomes. The study provides preliminary evidence that treatment gains in youth mental health outcomes are observed when caregivers perceive support in treatment processes. Suggestions for future research are made, stressing the importance of caregivers and providers working together and describing needs related to future scale improvements.     

The Elderly Person and Family Life

The relationship between an elderly person and other members of his family is worthy of study from the point of view of both young and old. The extended family, rather than the nuclear or immediate family, is the relevant unit for the majority of people including the elderly. The evidence available from industrialized societies shows that the elderly can gain considerable support during the process of ageing by being included in the modified extended family. While institutions for the elderly are undoubtedly necessary, more elderly people could remain integrated in the normal community providing family life survives and is supplemented by an active policy of home help.     

Community Integration of the Elderly in Foster Family Care

Currently the care of the elderly is part of a nationwide trend of deinstitutionalization. However, community placement of formerly institutionalized clients, particularly through the mental hygiene system, has in some instances met with negative community response. Extent of resident participation in the community and degree of community acceptance were studied through interviews with caretakers ir) 100 foster homes, housing one to four clients over 60. More than 3/4 of the residents were reported as having met neighbors. One-third of the residents take walks in the neighborhood, with an additional 2/5 visiting in the neighborhood. One-third participate in activities such as senior centers or church groups. Contrary to expectation, those homes associated with the mental hygiene system reported greater participation in community activities than did those sponsored by the social services system. Negative response from the community occurred in only about 10% of homes. Thus, foster family care appears to show promise both for community integration of the elderly and for community acceptance of the deinstitutionalized.     

Functional Status of the Non-Institutionalized Elderly in Sweden

Abstract

Functional ability was assessed in a randomly recruited population of elderly persons, totalling 553 individuals, living in their homes in four municipalities in central Sweden. These subjects were interviewed at home, using the Sickness Impact Profile. The response rate was 75%. No significant differences in functional ability were found among the municipalities. For those subjects 85 years old or more, average physical and overall functional ability was significantly worse than among the 81-84 year olds. Women had a significantly lower functional ability than men. Less well educated elderly persons had lower psychosocial and overall functional abilities than had the better educated. Physical dysfunctionbut not psychosocial dysfunctionwas significantly associated with formal and informal home help.     

The Sole Parent Family: Family and Support Networks

This paper reports on a research project that focused on the experiences of ten sole parents and their support networks. Results indicate that they relied both on informal support networks and welfare organizations in the initial period of sole parenthood but that this reliance waned over time. Participants accessed church groups, cancer support groups, governmental agencies, financial institutions, and counselling services. After the initial use of support networks, many of them became involved in recreational activities that they had not participated in during the course of their marriage. They emphasized the importance of friends who were influential in assisting them to cope with the initial stresses of sole parenting. Most were critical and disillusioned about the level and type of assistance from the extended family and the emotionally charged responses to their situation. They were also critical of Government services and felt stigmatised by the treatment they received.     

Economic Status,Family Dependence,and Health Outcomes of Older People in Western Rural China

There is a deficiency in empirical knowledge on the physical and mental health of lower-income older people with weak family support in western rural China. To address this research gap, this article uses the data from the 2014 China Longitudinal Aging Social Survey to analyze the disadvantaged situation of older people in western rural China through a regional comparative analysis. Our sample consisted of 7,138 older adults aged 60 or older in eastern and western, rural and urban China. We find that lower personal income is significantly associated with poor physical and mental health. Economic support from families means more for older people when they have a disability related to activities of daily living in western rural China. Fostering stronger family support networks might improve the mental health status of older people in western rural China. Our study suggests a broader scope for the state to play a greater role in economic empowerment and in the development of policies to effectively meet the present and future needs of older people in western rural China or other countries with an imbalance in the distribution of the aging population and welfare resources.     

Rethinking Family Support in the Current Policy Context

This article uses the concept of ‘the social investmentstate’ to understand key aspects of New Labour’spolicies in relation to welfare reform. It argues that ‘investingin children’ and creating ‘responsible parents’are vital features of many of the policies and service initiativeswhich have emerged since 1997. Such features have considerableimplications for policies and practices in the arena of familysupport. The article goes on to outline aspects of an importantcritique of the social investment state which has emerged fromthose engaged in research and policy analysis who argue fora ‘political ethics of care’. It argues that thisperspective offers important possibilities to family supportadvocates not only for critique, but also for articulating muchneeded policy alternatives to those currently being promotedby New Labour. It also signposts the importance of conductingongoing research into the meanings which are being attachedby individuals to complex and contested terms such as ‘family’and ‘support’.     

Health Service Utilization and Expenditure of the Elderly in China

Using data from the China Health and Retirement Longitudinal Survey, we employed counterfactual propensity score matching to examine the association between income and health service utilization and expenditure of the elderly in China. The results demonstrated that income did not differentiate whether the poor elderly in China visited a doctor when suffering an illness, but their expenditure on medical treatment was significantly associated with income. Subgroup analysis further indicated that the medical demands of female, older, and rural elderly were more likely to be reduced by their income compared with their counterparts.     

Health Care Utilization Among the Elderly

The present study represents and attempt to develop a conceptual framework which provides a theoretical linkage between predisposing, enabling, and need for care factors and the utilization of physicians' services within an elderly population. Multiple regression and path analytic techniques are used to access the relative importance of these factors in determining health care utilization. The findings indicate, among other things, that the measures of morbidity, or the need-for-care, are the most important variables determining use. The substantive findings and their implications for the development of health care policies and programs for future research are highlighted.     

老年人精神赡养的伦理思考

我国当今社会,老年人的物质需求已逐渐得到满足,老年人的精神赡养便成为了老龄人赡养的重要方面.近期关于老年人精神赡养如何实施的话题引起了人们的广泛关注.社会和政府在构建社会养老保障制度的同时应该着力从伦理的角度出发,建设一种精神赡养的社会伦理网络,使得老年人精神赡养得到广泛的伦理支持.