Long-Term Care of Older Adults in Malta: Influencing Factors and Their Social Impacts Amid The International Financial Crisis

ABSTRACT

This article explores recent changes in long-term care (LTC) for older persons in Malta, resulting from restructuring or other contextual factors related to the international financial crisis. The ageing population continues to grow, while traditional ways of providing care for the ageing population are progressively dwindling. Waiting lists for residential care have grown longer, although public-private partnerships have served to shorten these lists to some degree. Community care services are not keeping pace with need, and the frail elderly wishing to remain in their own homes often cannot do so without significant assistance from other sources.

Service recipients fall into four groups: those affording private residential care; those granted a government-subsidized residential bed; those cared for at home by relatives; and those similarly cared for by nonfamily live-in caregivers with (or without) input from family members. Existent data are reviewed and analyzed along with a focus group of 30 stakeholders to explore this topic further. Future recommendations are made and consequences are explored as caregiving options move away from the responsibility of the traditional family system toward greater pressure on state-provided care, use of expensive private care, and waiting lists to secure services.     

Older Workers in Intergenerational Child Care

Thirty-four older workers in one of five intergenerational child care settings participated in a study exploring the effects of their participation in intergenerational child care programs. The purpose o the study was (1) to identify and describe a sample of older child care workers and (2) to identify characteristics of the older child care workers or the work experience which significantly impact on their lives. The older workers completed a written questionnaire, standardized life satisfaction scale, and interviews. The results suggest that participation in intergenerational child care programs supports the notion of generativity and enhances productive aging. Older workers reported increases in feeling needed, valued, and a sense of self-worth, and increased social contact. Over 90% of the older workers reported that their job expectations were met and that they felt the children had benefitted from their work. Positive changes in attitude about children's growth was positively related to the older workers' personal growth. Older workers also reported greater personal growth when they worked in excellent child care centers as compared to good or fair quality centers. Younger teachers reported positive changes in the classroom environment with the presence of older workers. These findings have implications for training older adults as child care workers and for social policy issues concerning older citizens' roles in our society.     

Intergenerational Conflict,Attitudinal Familism,and Depressive Symptoms Among Asian and Hispanic Adolescents in Immigrant Families: A Latent Variable Interaction Analysis

ABSTRACT

Research has shown an association between intergenerational conflict (IC) due to acculturation and negative mental health outcomes, including depressive symptoms, among Asian and Hispanic adolescents from immigrant families. Using the data from the first survey of the Children of Immigrants Longitudinal Study, which included a culturally diverse sample of second-generation immigrant children, this study examines whether attitudinal familism (AF) moderates the effect of IC on depressive symptoms among Asian and Hispanic adolescents. Latent variable interaction models involving multiple-group comparisons were established. Results show that there is a significant buffering effect (b = –.05, p < .001). Specifically, a high level of AF is generally associated with fewer depressive symptoms compared with a low level of AF. These findings may inform the development of social service programs that aim to reduce IC by exposing immigrant adolescents to more traditional cultural values. Future research implications are discussed.     

Observational Research in Intergenerational Programming

Summary

Research in the field of intergenerational programming is rapidly growing in both quantity and quality. Both those who plan and work directly with intergenerational program participants in the human services and those who hold positions as researchers and evaluators need to be encouraged to research and evaluate their programs. We argue that observational research, though not without its shortcomings, should be more widely used to study and evaluate intergenerational program effectiveness and the relationships among people within them. We also provide some examples of observational strategies useful in practice-based research. We conclude that by recording details of the actual program interactions and relationships and examining them carefully or preserving them for later scrutiny, intergenerational program planners can learn to make relationship-based interventions successful and rewarding for their clients and themselves.     

Should I Stay or Should I Go? Children's Placement Preferences Longitudinally

ABSTRACT

Perceptions of permanency from the child's perspective can aid in giving voices to children impacted by foster care, thus promoting their personal sense of empowerment. This research represents a longitudinal assessment of how children living in foster care perceive permanency; specifically, their placement preferences while living in temporary foster care. Analyses were conducted on a subset of 2,671 children from the National Survey of Child and Adolescent Well-Being (NSCAW). Utilizing attachment and social capital constructs, children's preferences were predicted using Generalized Ordered Logistic regression analyses. Results demonstrated differences in children's perceptions and preferences for permanency at three waves of data collection.     

Decision Making in Long-Term Care

Abstract

This article reports findings from a qualitative study of approaches to long-term care decision making used by older adults (N = 52) who continued to reside long-term in the community following nursing facility pre-admission screening. Older adults used different approaches to decision-making (autonomous, collaborative, and delegated) while seeking the most appropriate care setting. Factors such as mental capacity, the role of family caregivers, and self-advocacy skills influenced the choice of decision-making approach. Findings also illustrate how older adults moved through multiple pathways in order to reach their eventual long-term residence. These findings are discussed in terms of their implications for clinical practice and research.     

Perceptions of Students about Younger and Older Men and Women who May Be Homeless

ABSTRACT

Future human service providers will interact with homeless persons in health, mental health, and social service practice contexts. This study investigated the perceptions of students enrolled in social work courses who are pursuing degrees in human service programs toward older and younger female and male homeless individuals. Respondents (N = 207) were given one of four vignettes in which a character was identified as an older male, a younger male, an older female, or a younger female who was frequently seen near an interstate highway, talking to him/herself and appearing unkempt, thin, and frail. Most respondents perceived the vignette character as mentally ill, neglectful of health, likely to have HIV, tuberculosis, hepatitis A and/or hepatitis B and/or hepatitis C, likely to experience suicidal thoughts/ideation, and to have head lice/scabies/body lice. Older men were more likely to be perceived as military veterans with a history of mental illness and substance abuse. Older women were least likely to be perceived as having a history of substance abuse or using a handout to purchase ethanol. Older women were perceived to be homeless because they could not afford other living accommodations. A general linear model revealed significant differences in 7 of 41 items that respondents answered based on the gender and age of the vignette characters. These perceptual differences between male and female homeless persons will require additional investigation.     

Primary Caregivers and Chinese Elders’ Demand on Community Services

Abstract

The most influential model explaining the elderly’s service use is Andersen and Newman's model. But the applicability of the model on elders’ demand on community services has not been tested, especially in developing countries such as China. This research tested the applicability of the model by studying how primary caregiver relations to the elderly influence Chinese community-dwelling elders’ demand on community services. With a total of 2,124 respondents aged 65 and older who reported primary caregivers, six primary caregiver relations were examined: son, spouse, daughter, daughter-in-law, unmarried son and daughter, and other. Data came from the 2014 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Results indicated that: (1) Elders cared for by daughters-in-law showed a significantly stronger tendency of expecting community services than elders cared for by other caregivers among both rural and urban areas. (2) Elders were least likely to expect community services in two cases: urban elders taken care of by daughters and rural elders whose primary caregivers were unmarried sons and daughters. Since Chinese elders cared for by different caregivers tended to seek community care in different manners, future research may study how suitable community service programs can be developed to well meet the needs of various elderly groups.     

The Experiences of Reciprocity among Filipino Older Adults in Canada: Intergenerational,Transnational, and Community Considerations

ABSTRACT

This article illustrates the concept of reciprocity in the context of immigrant families. It recommends that definition of reciprocity account for exchanges beyond the immediate family, and render visible the simultaneous location of older people as care recipients and providers, and care arrangements across generations, borders, community, and time. Adopting a critical ethnographic study on the aging and care experiences of older Filipinos in Canada, this article analyzes data from extended observations and in-depth semi-structured interviews with 18 older people, 6 adult children, and 13 community stakeholders. Findings highlight the unique configurations of care among the Filipino community whereby older people engage in care exchange as active participants across intergenerational, transnational, and fictive kin networks.     

Care Leavers in Israel: What Contributes to Better Adjustment to Life After Care?

ABSTRACT

The present study examines the adjustment of youth leaving residential treatment in Israel in three core areas: military service, accommodation, and financial status. A sample of 277 adolescents (aged 17–18 years old) in educational and welfare residential placements were interviewed a few months before leaving care, and 236 of them were interviewed 1 year after. It was hypothesized that optimism, higher perceived sense of readiness to leave care, and higher social support of family, friends, and staff are associated with better outcomes in adjustment to military service, accommodations, and economic status. Findings show that 70% of care leavers were drafted to the (compulsory) military service, a sign of good adjustment in Israel. Yet, they have significant difficulties in the areas of accommodations and financial status. Optimism and perceived readiness for independent living while still in care were positively correlated with adjustment to the military service. Mother's support was positively correlated with care leavers’ economic status and stability in accommodations. These findings highlight the importance of designing programs that include specific attention to needs and challenges while youth are in care and immediately after they leave. Follow-up and longitudinal studies are suggested.     

Experiencing Civil Unrest: Elder Voices on Ferguson

ABSTRACT

Ferguson, Missouri became the center of the nation’s attention when an unarmed African American teenager was killed by a Caucasian police officer. Civic unrest continued for weeks. The aim of this study was to learn how older adults experienced the social unrest. Ten focus groups were conducted with 73 participants. Eight themes were identified. Issues related to safety were most commonly discussed. Participants reported a breakdown in intergenerational communications and expressed a desire for more exchange. Findings are being discussed with relevant organizations to increase the involvement of older adults in on-going community development efforts and to provide opportunities for intergenerational dialogue.     

“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.     

Sexual Behaviors and Perceptions of HIV Risk in a Multiethnic U.S. Sample of Women Who Have Sex with Women

Abstract

This study investigated the sexual practices and perceptions of HIV risk in a national sample women who have sex with women (WSW). A multiethnic sample of 239 WSW aged 18–68?years attending GLBTQ pride events in three U.S. cities (Chicago, Atlanta, and Fort Lauderdale) completed an anonymous survey regarding their sexual behaviors, thoughts and perceptions of HIV risk. In the past 6?months, 18% of participants reported one or more male partners. Perception of HIV risk was associated with having more male partners (r?=?.244, p?r?=?.185, p?r?=?.191, p?r?=?.169, p?r?=?.208, p?相似文献   

Examining Depression,Anxiety, and Foster Care Placement as Predictors of Substance Use and Sexual Activity in Adolescents

ABSTRACT

This study investigated the impact of anxiety and depression on sexual activity and substance use behaviors in a sample of 56 community- (traditional living arrangements) and foster care-dwelling adolescents aged 12 to 17 years. It was hypothesized that higher levels of anxiety and depression would be related to higher rates of risky sexual activity and substance use. Regression analyses were used to examine impact of the internalizing predictors on the risky behaviors. Results of the sample were presented with group membership emerging as a robust predictor of both sexual activity and substance use. Results suggest that adolescents within out-of-home care are at increased risk for engaging in these behaviors when compared with community-dwelling peers, and they may benefit from specific interventions aimed at decreasing participation. Future research may focus on assessing the effectiveness of interventions for these youth.     

Challenging the Myths of Black Women—A Short-Term,Structured, Art Experience Group: Exploring the Intersections of Race,Gender, and Intergenerational Trauma

ABSTRACT

The authors describe a short-term structured group process for African American women in the suburbs of Washington, DC, highlighting the perspective of the group leaders. The group was started to address the unique needs of African American women who are also survivors of childhood abuse and neglect. The group leaders used discussion and art in the group to explore the intersections of race, gender, and intergenerational trauma. Having shared experiences with the participants of the group, the authors explore the ways the group leaders were changed and challenged in the process.     

Admission to Nursing Homes in Taiwan

The population of Taiwan is facing a radical ageing process. A proportion of the growing number of people aged 65 and over is expected to need nursing home care. This research concerns the family context of decision‐making in the process of admission to a nursing home in Taiwan. Employing survey data from interviews with elderly people in nursing homes (235 interviews) and their carers/key families (265 interviews), the factors affecting their views about admission were explored. Bivariate analysis and a logistic regression model were also used to examine perceptions of alternatives to nursing home care among family members with elderly relatives in nursing homes. Most elderly people in Taiwan are cared for in their own homes by their families but, in some circumstances, entry to a nursing home seemed inevitable. This research found that the decisions were taken mainly within a family context. The adult children of the elderly people, carers/key families’ preferences and the availability of carers influenced the decision. Apart from the important need factors of elders, families’ views about alternatives to nursing homes were significantly influenced by their preferences. This study has important implications for long‐term care in Taiwan. It is hoped that this will be needs‐led, both by elderly people and their families.     

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.     

Implementing reverse mentoring to address social isolation among older adults

ABSTRACT

Reverse mentoring is a means to address the social work Grand Challenge of social isolation. Among older adults, reverse mentoring can improve social connection by increasing the digital competence of older adults so they can use technology for social benefit, and by facilitating intergenerational connections with young adult mentors. In this paper, reverse mentoring is examined within an intergenerational program that serves older adults and utilizes the native technological knowledge and skills of young adults who mentor older adult participants. Qualitative data were collected through young adult mentor logs of each session, and through open-ended questions on the post-surveys collected from older adults and young adult mentors. Qualitative analysis revealed three themes related to social connection: (1) an increased sense of self-efficacy for older adults as they build confidence in technological use, and for young adults as they develop leadership skills through mentoring, (2) the breaking down of age-related stereotypes, and (3) intergenerational engagement and connection. The findings demonstrate that reverse mentoring can be used in various settings to decrease the social isolation of older adults by developing intergenerational connections and increasing older adult usage of technology.     

‘New Wine in Old Wine Skin’: Public Perceptions of NHIS Per-Capita Payment System and Implications for Health-Seeking Behavior in Ghana

Abstract

The article examines public perceptions of capitation payment system and the implications for health-seeking behavior in rural and urban Ghana. Drawing on qualitative approach, the study employed focus groups (n?=?20), in-depth (n?=?20), and key informant (n?=?14) interviews with community-based adult men and women, aged 18–65?years in Ashanti Region. Tape recorded interviews were transcribed and analyzed thematically. Results indicated that majority of respondents have heard about the capitation but only a small proportion of them understood what the whole policy entails and the rationale for its introduction. While general dissatisfaction with and negative perceptions of the capitation still persisted among majority of the study population, this did not translate into nonuse of health services. For subscribers to derive optimal benefits from the capitation, political commitment in continuing public education using the most accessible media modulation is key. More importantly, public and private healthcare providers should increase investments in improving healthcare delivery system. Future studies should employ quantitative approaches with region-wide sample in order to confirm the relationships between capitation enrollment and health-seeking behavior.     

A theoretical model of religiosity and drug use with reciprocal relationships: A test using structural equation modeling

Abstract

This study of 1093 adolescents from 6 public high schools was designed to test a hypothesized model formulated by theoretical elaboration of control theory with elements from social learning theory using structural equation modeling procedures. The primary purpose was to establish that religion is relevant to illicit drug use when its direct, indirect and reciprocal effects are tested within a more complete system of relationships than found in existing studies. Most aspects of the model were supported by data and religion had direct inverse effects on illegal drug use for all adolescents studied. However, the feedback effects of drug use on religion were significant only among younger adolescents and females. Other age and gender differences were observed when the hypothesized model was tested with structural equation modeling procedures. The implications of these findings were discussed in regard to future conceptual work and intervention.