The “Socialization of Elderly Hospitalization” in China: Development,Problems, and Solutions

ABSTRACT

Objectives to analyze the development of the elderly patients with chronic diseases and to make some suggestions for the elderly social hospitalization. Methods By using yearbook data and theoretical analyses, the paper respectively presents the problems and furthermore solutions of China's elderly services. Results The elderly patients with chronic illnesses have formed a new group, and the phenomenon of “socialization of elderly hospitalization” has become a major social risk. Discussions China needs to promote the idea of “long-term care” in elderly social security, establishing long-term care insurance and fostering a private, professional elderly service system.     

Preparing Social Work Students to Work with Grandparents in Kinship Care

Summary

Grandparents in kinship care represent an expanding population of older adults assuming primary parenting responsibilities for their grandchildren at a time when many grandparents may also be experiencing developmental changes accompanying their own aging process. Research documents a lack of social workers prepared to respond to the needs of an aging population in general, and grandparents in kinship care in particular, as curricular content on this population has been limited in undergraduate and graduate social work programs. This article describes an infusion model proposed for an undergraduate social work program's GeroRich Project designed to introduce content on an aging population in four foundation courses to expand students' knowledge of older adults and grandparents as kinship care providers.     

Chapter 17. Rural Mental Health

SUMMARY

Mental health services available in many rural communities are too limited in scope and availability to meet the needs of rural citizens. The future of mental health services for the rural poor will be impacted by state government decisions about Medicaid funding priorities. It is important that rural practitioners, especially those that work in the fields of mental health, health, and aging services, engage in advocacy for better coverage of the rural poor and low-income elderly persons. This chapter discusses issues of advocacy related to improving the provision of mental health services to older rural citizens as an important goal in the larger effort to expand and improve rural mental health service delivery throughout the nation.     

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.     

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.     

The Senior Outreach Program of Park Ridge Mental Health

Abstract

Availability and accessibility of mental health services for the elderly is woefully inadequate, failing to recognize the diversity of needs in the older adult population. Stigma, confusing and exclusionary insurance regulations and restrictive mental health center policies have both limited and discouraged treatment interventions. Through innovative case finding, programming and funding arrangements, the Senior Outreach program of Park Ridge Mental Health in Rochester, New York, has proven effective in identifying and providing outreach mental health services to elderly individuals. The program utilizes a human services agency model, yet operates within a large heath care system as part of a continuum of psycho-geriatric services.     

The Elder Latino Population in Holyoke,MA

Abstract

Holyoke's elderly Latino population's needs, as well as their patterns of service utilization, were explored through detailed interviews of 13 individual elders and a focus group of an additional 10 participants. The research uncovered a gap in the web of resources available, with some services, such as medical care, functioning well. However, there continue to be unmet needs, particularly in the areas of transportation, social and recreational activities, and sense of safety. Negative perceptions of aging and complaints of anxiety, depression, and boredom are also an area of concern.

The barriers to use of services were also explored. Recommendations for the enhanced provision and utilization of services, many suggested by the elders themselves, are offered. Implications for social work research and policy on, and practice with, Latino elders are discussed.     

Transformation of Social Care Services for the Elderly in Slovakia

ABSTRACT

The main objective of this article is to present a theoretical framework for the relevant historical, economic, demographic, and political factors influencing the transformation of social care services for the elderly in Slovakia. A major restructuring of the social care services for the elderly is necessitated by the aging of the Slovak population (demographic reason), the path dependency of the current Slovak elderly care system (historical reason), the growing purchasing power of older people and the general population (economic reason), and new requirements formulated by the European Union and the general public (political reason). Historical documents, legislative acts, strategic documents, international project documents, and statistics were reviewed, and 34 open-ended interviews within the framework of two case studies were carried out in order to obtain qualitative and quantitative data. The theoretical framework and the results based on those interviews indicate that the Slovak social care service for the elderly may turn out to become more similar to the advanced Central European systems, but also that prompt legislative and financial changes are required. Nevertheless, the future direction can only be more precisely identified when more case studies can be compared with one another.     

A Pilot Study About the Needs of Older Gays and Lesbians

Abstract

In a pilot study, a population of gay and lesbian elders were surveyed to determine what types of long term plans they have made in preparation for their old age, what types of information they feel service providers need to know to better meet their long-term needs, and what is their perception of aging. The results of this pilot study demonstrated that almost three-fourths of the total sample have started to make plans for growing old. The respondents reported that social workers needed to be more knowledgeable about gay lifestyles and the importance of their partners. It was also found that the views of aging became more positive as the gay and lesbian individuals grow older.     

A Qualitative Exploratory Study on the Service Delivery System for the New Long-Term Care Insurance System in Korea

ABSTRACT

To cope with the rapid growth in its aging population, the Korean government introduced a new social long-term care insurance (LTCI) system for elderly people beginning in July 2008. This study aims to understand how National Health Insurance Corporation (NHIC) staff and home-visiting service providers experienced and evaluated the new service delivery system. A total of 26 semistructured in-depth interviews were conducted with NHIC staff primarily responsible for the functional assessment of the elderly and the home-visiting service providers responsible for providing direct services to elderly clients. In summary, interviewees had negative experiences with the new service delivery system such as difficulties in carrying out their roles. The findings suggest that Korea's new LTCI service delivery system faces challenges and that a more active role for the Korean government, especially regarding the introduction of a proper care management system, is needed to address the issues. Future research with larger sample sizes is needed to examine and understand the issues in detail.     

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.     

Rethinking Needs Assessment in Planning Services for Older Adults

ABSTRACT

Needs assessments are widely used in the field of aging, and are considered valuable tools for planning service responses to unmet and undermet needs of older adults. This article describes a comprehensive needs assessment of Bermuda's older population and presents some of its findings to illustrate concerns about needs assessments that emerged from this experience. We suggest that even when needs assessments are carefully planned and adhere to generally recognized best practice principles, they may not be able to fully provide desired information. A revision of key assumptions about needs assessment is offered for researchers, planners, and community workers.     

Caregiver Support Groups: Finding Common Ground

SUMMARY

Members of caregiver support groups for the elderly have much in common but also bring to the group different experiences and attitudes. This article explores how group workers knowledgeable about significant caregiver differences and their effects on the group can enrich the group experience for all members. The four caregiver issues examined are: (1) past history between the caregiver and care recipient, (2) ability of caregiver to privately pay for home care, (3) views on long-term care placement in a nursing home, and (4) stage of disease or level of care needed by care recipient. Essential beliefs regarding the value of differences described by Northen and Kurland provide a framework for the group worker.     

Friendship Across the Life Cycle

Abstract

Using a group work model, this article discusses a short term group for older women developed to explore the importance of friendship in late life. In collaboration with group leaders, group members determined weekly topics that explored the significance of friendship through the life cycle. Social work group practice that focuses on the meaning and development of friendship for and with older women is presented as an effective therapeutic intervention for practitioners in settings such as community mental health clinics, senior centers, elderly housing, home care agencies and nursing homes.     

The Perceptions and Needs of Farm Dwellers Regarding Aging,Advanced Age,and Future Perspectives

Abstract

This article reports on a multidisciplinary study that was undertaken by the Faculty of Health Sciences of the Potchefstroom University for Christian Higher Education. This study was done on certain farms in the North West Province of South Africa and called the FLAGH study, meaning the Farm Labour, Agriculture and General Health study. This article reports on a need assessment of farm dwellers done during the second half of 2002 and focuses specifically on perceptions and needs regarding aging, advanced age and future perspectives of aged farm dwellers.

The objective of this study was to ascertain the psychosocial needs and problems of farm dwellers in order to eventually design, implement and evaluate a programme aimed at the improvement of the quality of life of farm dwellers. An exploratory study was done, utilising in-depth interviewing according to a schedule of both quantitative and qualitative nature. Certain aspects, like the attitude of the community towards the elderly, relationships of the elderly with peers, children, grandchildren and spouses were dealt with in this study. Topics like the needs or problems of the elderly, nearing death, old age homes and retirement were also covered in this project.     

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.     

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 Effect of Housing on Perceptions of Quality of Life of Older Adults Participating in a Medicaid Long-Term Care Demonstration Project

Summary

As the nation struggles with the great increase in the numbers of older adults, many questions arise about how to provide housing and long-term care options that will ensure the quality of life of older adults. This study demonstrates that older adults and their families perceive quality of life more positively once moved from a nursing home to an assisted living facility using Medicaid funds. Results of this exploratory study are promising and suggest that having housing options available across the continuum of care with individualized case management offers older