Anticipating relocation: concerns about moving among NORC residents

Most older adults prefer to live at home as long as possible, requiring supports and services to help them age in place. This study examines the relocation concerns of a group of older adults in a suburban naturally-occurring retirement community (NORC). Twenty-six percent of the 324 residents interviewed expressed concern about having to move in the next few years. Residents who were worried differed from those who did not worry on a number of demographic and biopsychosocial characteristics. Overall, residents present a profile of vulnerability that calls for preemptive action to help them stay in their homes. A NORC is an ideal setting in which to provide supportive services.     

Individual- and Contextual-Level Factors Affecting the Use of Social Support Services among Older Adults

ABSTRACT

By 2060, the number of Americans aged 65 and older is expected to more than double, while the number of Americans aged 85 and older is expected to nearly triple. As the nation's aging population grows, older adults will need to rely on social support services, such as transportation and housing services, in order to remain active and lead independent lives. In this study we use data collected from the elderly supplement of the Southeastern Pennsylvania Household Health Survey (SPHHS) (n = 3,042) to explore the relationship between the availability of elderly specific social service providers and utilization of social support services among older adults. We find that while the number of elderly specific social service providers can increase use of social support services among older adults, its impact is relatively minimal. We find that individual factors, instead, are stronger predictors of service use. This is a finding that should be particularly encouraging for elder care providers who may not have the resources needed to undertake large structural changes (like building new facilities). Still, future research should explore how the availability of a broader range of elderly specific social services (than explored in this study) impacts use.     

Care of Older Adults in Iceland: Policy Objectives and Reality

ABSTRACT

We examine the implementation of the Icelandic government's policy on formal care of older adults in Iceland. The policy as expressed in legislation and other policy documents is to ensure access of older adults to the appropriate level of health and social care services. How does the actual level of formal care compare with the policy objectives? Does there exist an implementation deficit, and if so, why? We address the question by analyzing Icelandic and international statistical databases. The findings reveal a gap between the aims of the current policy and its delivery. As elsewhere in the Nordic region, the policy allows for the emphasis to be on home-care services in which the individual's needs are assessed comprehensively. Administrative problems and insufficient resources to better understand and explain the problem are identified. Current steps to address the problem include the necessity of a comprehensive evaluation of the level and quality of elder-care services in Iceland, which would help compensate for the shortcomings of the existing public statistical databases. In future research, it is necessary to analyze how services can be coordinated while increasing responsiveness to the voices of older adults and their relatives on the care of older people.     

Community Service Use by Older Adults: The Roles of Sociocultural Factors in Rural–Urban Differences

ABSTRACT

This study examined the influence of sociocultural factors in explaining the rural–urban differences in home and community-based service (HCBS) use among older adults. Survey data of 228 older adults living in Alabama were analyzed. Sociocultural factors included participants’ perceptions of service availability, attitudes toward seeking formal help, informal support, and religious behaviors. Rural older adults were less likely to use HCBS than their urban counterparts (p < .05). An interaction effect between perceived service availability and church attendance was found. These findings suggest a need for collaborations between community aging services with religious organizations to ensure existing programs are accessible to older adults living in rural areas. Future research based upon large probability samples is needed to shed more light on the relation between church attendance and service use.     

Ageing-in-place in studio apartments in Singapore: maintaining independence in community living

Abstract

Living alone in later life is increasingly a common style of living in Singapore. We investigated the extent of maintaining independent living in a studio apartment using a survey of older residents (n = 925), focusing on three aspects of coping strategies: self-care management, social support, and use of social services. As compared to older adults who lived with others, those who lived alone had better self-care management, tended to rely more on friends and neighbours, and indicated higher use of social services. Those living alone also showed higher awareness in managing their health. This study provides valuable insights to understand the issues on coping strategies involved with living alone in later life.     

Current Developments in Social Care Services for Older Adults in the Czech Republic: Trends Towards Deinstitutionalization and Marketization

ABSTRACT

Deinstitutionalization and marketization of eldercare has been delayed by 20 years in the Czech Republic compared to Western Europe, and it takes place in a completely different context, characterized by the legacy of communism, a growing older population, and less generous public subsidies. This study is the first in the Czech Republic to examine how deinstitutionalization and marketization effect implementation of these principles on the availability and quality of eldercare services at regional and municipal levels. A mixed-method approach was used, combining several data sources (policy documents, administrative data, statistics, expert panel, and secondary use of qualitative data). The findings suggest that the support for and availability of home-based care has declined, despite the ever-increasing number of older adults and policy preference for deinstitutionalization. Furthermore, home-based services have failed to adjust to growing care needs of older adults (e.g., inflexible schedules, limited provision of time-demanding care, inadequate staff composition). This situation occasioned an unintended outcome: the emergence of nonregistered, semilegal, for-profit nursing homes offering low-quality care and poor working conditions, and subject to no quality control. The health and even lives of older adults are at risk if they choose such services. Research is needed to study older adult decision making and offer them tools to identify and avoid questionable services.     

Senior Citizens Centers

Abstract

This study extends exploration of what senior centers offer, who participates, and what they gain. Center staff surveyed 856 participants in 27 senior centers regarding personal characteristics, program participation, and acquisition of vital information. Although senior centers are considered conduits for group activities and enrichment for older citizens, this investigation indicates that personal characteristics of participants exert a notable influence on the experience and perceived benefits of activities engaged in at senior centers. These findings should interest providers of aging services and advocates who view the senior center as an important vehicle for enhancing independent living for older adults.     

Psychological Vulnerability and Gambling in Later Life

ABSTRACT

Objectives: Because behavioral problems often emerge from maladaptive coping methods, we investigated whether unmet basic psychological needs evolve toward a level of psychological vulnerability that puts older adults who gamble at risk for becoming problem gamblers. Methods: Data from a community sample of 379 adults ages 60 and above were analyzed using structural equation modeling. Participants responded to items regarding their demographics, gambling frequency, engagement in at-risk gambling behaviors, and the extent to which their basic psychological needs were met. Results: Satisfaction of basic psychological needs among older adults who gamble was negatively associated with their being at risk for developing a gambling problem. Satisfaction of basic psychological needs also mediated the negative effect of socioeconomic status on at-risk gambling behavior. Conclusion: Social workers should become mindful of how older adults, who are confronting psychological vulnerabilities in later life, might well turn to gambling as a maladaptive coping mechanism.As per journal style, abstract must not exceed100 words. Please amend accordingly.     

Formal Alternative Transportation Options for Older Adults: An Assessment of Need

ABSTRACT

This study measured the need for formal alternative modes of transportation among older adults by applying traditional factors of the Behavioral Model. Survey participants who regularly drove were compared to those who could no longer drive. Race/ethnicity and self-reported health were significant predictors of perceived need for transportation services for both groups. However, income and service awareness were significant predictors only for drivers, while family proximity was a significant predictor only for non-drivers. Results suggest the importance of gaining a better understanding of the factors associated with need for senior-focused transportation services to more effectively plan such programs.     

Hospice Use by Older Adults Knocking on the Door of the Nursing Facility

Abstract

Since 1983, federal funding has been available for hospice services. However, research studies have found that hospice is underutilized by people with terminal illnesses and their families. Low-income older adults are particularly at risk for underutilization. This study examined utilization of hospice services by nursing home applicants in one Midwestern state. Characteristics of users and non-users, and potential barriers to hospice use were examined. Findings further document that hospice is underutilized, especially by the Medicaid population, and point to barriers to hospice utilization. Specific recommendations are made to help practitioners increase hospice access.     

Trajectories of Community-Based Service Use: The Importance of Poverty and Living Arrangements

ABSTRACT

This study examined how older adults’ living arrangements and poverty status affected their use of in-home health, functional, and out-of-home services over time. Using eight waves of data from the Korea Welfare Panel Study, we employed a logistic mixed-effect model to analyze how poverty and living arrangements affect community-based service use. Living-alone older adults and elder-only couples were more likely than co-residing households to use services. Elder-only couples, when poor, were more likely to use in-home and out-of-home services over time. Understanding predictors of community-based service use over time enables researchers and policymakers to better understand the process of aging-in-place.     

Research with Older Adult Methadone Clients: The Importance of Monitoring Suicide Ideation

ABSTRACT

This study reports on the importance of monitoring suicide ideation among older adult research participants. A recently completed randomized controlled trial of older adults who are current clients in methadone maintenance treatment (MMT) served as a case study to elucidate a suicide protocol that was designed to account for the potential instances of suicide ideation within the research project structure. As the numbers of older adult heroin users increases, this study’s findings seek to influence research protocols that involve older adults with addictions who may be particularly vulnerable to suicide risk due to comorbid psychiatric conditions and psychosocial adversities.     

Discharge Planning

Discharge planning services have become very important to older adults who are subject to shortened hospital stays due to the prospective payment form of reimbursement based on diagnostic related groups (DRGs). A study of older adults discharged from three acute care hospitals in New York City shows a direct association between patients' satisfaction with their discharge plan and the number of services arranged by discharge planners. Patients told, "your DRGs are up" as the reason for their discharge, needed the greatest amount of help with activities of daily living. Implications for social workers offering discharge planning services are addressed.     

Intimate Partner Violence Survivors’ Unmet Social Service Needs

ABSTRACT

Women who have experienced intimate partner violence (IPV) victimization are at risk for physical and mental health problems, as well as social and economic challenges. In this cross-sectional study, 173 adult, English-speaking women who had experienced police response to IPV completed a self-report questionnaire about their use of, interest in, and need for various social services and whether or not each type of service helped (or would help) them to feel safer. More than three quarters of the participants reported a current need for health and economic support services. There was less interest in traditional IPV resources: law enforcement and domestic violence counseling or shelter. Expanding services to meet survivors’ needs for health care and economic independence may facilitate long-term safety. Recommendations for further research in this area are provided.     

Type of Volunteer Experience and Health Among Older Adult Volunteers

Abstract

The purpose of this investigation was to ascertain if the type of volunteer experience was related to the physical health or psychological well-being of older adult volunteers. A central pattern emerged from the data: the type of, as well as the number of, hours donated to a volunteer activity were associated with psychological well-being. Implications for social workers involved with volunteer programs and services are discussed in terms of volunteer recruitment and retention, and the need to develop more significant volunteer roles, especially for low-income older adults.     

Pathways to Service for Older Persons

Abstract

As services for older persons continue to shift from hospital and nursing home care to greater reliance on support for care at home, the need to understand the ways older persons obtain services becomes more important. This study examines the use of home-delivered meals as a case study to gain insight into the process of service use from the recipients' point of view. It explores the research question: What are the pathways by which older persons acquire home delivered meals? Narrative analyses of structured and unstructured questions asked of thirty frail older persons suggested that the process of acquiring home delivered meals was accompanied by patterns of adjustment in shifting between independence and dependence in managing loss of physical function, and themes of isolation, loss, and abandonment. The results provide insights for social workers in providing the support needed for the role transition that service acceptance symbolizes for older adults.     

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.     

Providing Mental Health Services to Older People Living in Rural Communities

Summary

Rural dwelling elders who experience mental health problems often have difficulty finding help since rural communities often lack adequate mental health service providers. This paper reports on the initial phase of a 5-year, interdisciplinary clinical research study that is testing the effectiveness of providing a home delivered, therapeutic psychosocial intervention, aimed at improving the emotional well-being and the quality of life of medically frail elders who live in rural communities. In the early phases of this study, the clinical research team encountered a number of interesting and often unanticipated challenges as it attempted to recruit study participants and provide services to them. In this article, we examine these challenges and share what we have learned so far about providing mental health services to elderly persons living in rural environments.     

Chapter 16. Future Training and Education Recommendations for Rural Gerontological Social Workers

SUMMARY

With the increasing number of older adults, social work students need to be prepared to work with this population in a variety of settings. Rural areas may have high concentrations of older adults including those who age-in-place, and those who relocate to retirement areas in small towns and rural communities. Within the curriculum, content on health care, economics, and leadership/decision making need to be included to prepare students for practice in these areas. In addition, programs need to actively seek students who have an interest in working within more rural practice settings.