Solidarity and tension between age-groups in the United States: challenge for an aging America in the 21st century

In this article, we argue that intergenerational tensions in the United States reflect a strategy for serving the aged that stresses the underlying values of individualism and self-reliance. Using national survey data, we examine the extent to which Americans' view of public responsibility for the aged has shifted between the mid-1980s and late-1990s, a period characterized by the intensification of "generational" politics, as well as a growing hostility toward "big government." We consider four factors that may be responsible for the escalation of intergenerational tensions as they are manifest in the erosion of public support for programs and policies serving the elderly: (1) Declining intergenerational solidarity with the aged ; (2) Increasing concerns over age-inequity in public programs ; (3) Increasing concerns over resource-inequity in public programs; and (4) Increasing opposition to big government . Results indicate that the public has generally grown more apprehensive about the value and costs of government programs serving both the elderly and the poor. Yet, the fact that Social Security enjoys far more support than social programs serving the poor suggests that the elderly are perceived as more deserving of their benefits than other dependent groups in society. The public also appears increasingly reluctant to redistribute old age benefits according to need. Age-group contrasts revealed little evidence of direct tension between the generations. The results suggest that growing distrust of government and reluctance to help the poor has indirectly fueled opposition to public spending on the older population. Proposed changes to programs and policies affecting the elderly will need to take into account the ambivalence felt by many Americans toward a government they expect to make good on its promise to care for all older citizens, but to use fewer resources in doing so.     

The Probable Impact of Proposed Legislative and Budgetary Changes on the Lives of the Elderly and Their Families

The decade of the 1980s is characterized by economic uncertainty and political ambiguity regarding the direction of American public policy for the elderly. The purpose of this paper is to: (1) review demographic trends that particularly affect older adults; (2) summarize theReagan Administration's proposed cutbacks in programs and policies for the elderly; and (3) address the effects of these cuts on older individuals as well as on family systems across generations. It is our contention that the proposed budget cuts will seriously reduce a number of federal programs which have been developed to meet the needs of older adults. The impact of these cuts will be felt by all of the elderly and to a considerable extent, their families. However, the effects will be most severe for people who have poverty or near-poverty incomes, single women, and the "frail" elderly. The discussion suggests that these proposed budget cuts seem to reflect a lack of appreciation and recognition of both needs of the older individuals and those of their families. In addition, suggestions for program and policy directions, as well as further research are addressed.     

Formal Social Participation and Utilization of Community-based Services among Urban Elderly Chinese Living Alone in Shanghai,China

This research examined formal social participation among elderly Chinese adults living alone and the association between utilization of community-based services and formal social participation, which refers to participation in employment, volunteer jobs, and social groups. Using a secondary analysis on a survey data from a simple random sample of 228 adults aged 60 and older living alone in a Shanghai neighborhood, it was found that only small percentage of older adults living alone were involved in formal social participation. Hierarchical multiple regression analysis showed that use of community-based services is significantly associated with formal social participation among elderly Chinese living alone. Thus, future policies and programs should focus on strengthening community-based services for elderly Chinese, to more effectively promote and facilitate their social participation.     

The Older Woman:

Interviews were conducted with 302 elderly persons residing in two ethnic urban communities to determine their problems as well as their needs for diverse community services. Sex and living arrangements were found to be critical mediators of the demand for and use of various services. A greater proportion of women than men (particularly women living alone) reported needs for household, self-maintenance, and community services. Older women living alone were also more likely to report that they had experienced neighborhood problems. Implications for designing community-based services to better meet the needs of older persons in diverse living situations are discussed.     

"Religion is the finding thing": an evolving spirituality in late life

This paper discusses some important dimensions of faith and of the social contexts surrounding faith that are illustrative of continuity and growth in spirituality in the lives of older adults. Examples of an evolving spirituality emerge in the analysis of a recent qualitative research study that probed the nature of religious experience among thirty-one community-dwelling elders and fifteen elders residing in long-term care facilities. Face-to-face interviews with these forty-six older adults and with seven people who directed or assisted with formal and informal programs of faith comprise the empirical base for this paper. The seven people, I refer to them mnemonically as faithreps, worked in various ways in the long-term care settings to provide programs involving faith to older adults. The faithreps came from a range of educational and religious backgrounds and are not accurately or handily categorized. An evolving spirituality is shaped by the older person's links to the structural and the socio-relational contexts that have been created through interaction in the past as well as through interaction in the present. Moreover, the interaction of older adults and faithreps encourages spiritual growth because as social actors engaged with one another over a sustained period of time in an institutional setting, questions and dialogue about life and its meaning are regularly evoked. The social interactions that foster spiritual evolution may be an admixture of the secular and the sacred. Such socio-relational contexts were once part of the naturalistic settings of daily life among the old, but now must emerge through the efforts and planning of others. The salience of faith among present cohorts of older adults sensitizes us to the necessity of devoting more consideration to optimal ways of strengthening and building contexts that are conducive to the evolution of spirituality.     

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.     

The Heterogeneity of Socially Isolated Older Adults: A Social Isolation Typology

Recent statistics show a growing number of older adults who are living alone and are socially isolated. It is against this background that, in recent years, many interventions have been developed to address social isolation among the elderly. Evaluative studies show that most interventions are hardly effective, though. An important reason for this is the heterogeneity of the socially isolated. This article offers insight into this heterogeneity by presenting a typology with different profiles of socially isolated older adults and the intervention implications of this typology. The typology is derived from an extensive qualitative study on socially isolated elderly individuals in the Netherlands. The typology imposes some degree of order to a diversity of circumstances, ambitions, and possibilities of the socially isolated elderly, thereby deepening the understanding of the heterogeneity of this population. The definition of social isolation used in this study starts from a societal angle of incidence, namely the current policy context of Western European welfare states, in which governments emphasize the importance of independence and self-reliance of their citizens. Developed from that perspective, the typology provides a theoretical basis for applying interventions aimed at increasing self-reliance of social isolated elderly. This perspective on social isolation also has consequences for the way in which the effectiveness of interventions to alleviate social isolation is assessed.     

THE USE OF GROUPS IN DAY CENTERS FOR OLDER ADULTS

The paper describes groups currently used as the treatment of choice in a day center for older adults. It utilizes a framework of four group categories that have been developed and adapted to serve the needs of the impaired elderly population in a rehabilitalion orientated day center. The author supports the use of groups as "social treatment" and supplies examples of a number of group interactions as evidence of the effectiveness of group treatment for older isolated people.     

Self-Neglect and Neglect of Vulnerable Older Adults: Reexamination of Etiology

Using assessment and investigation data from the reported APS cases in Texas, this study examines the types of elder self-neglect and neglect, including medical neglect. It then examines the association between self-neglect and neglect and individual economic resources as well as health care and social service programs for the poor. The findings show that elder self-neglect/neglect is, in large part, attributable to frail older adults' and their families' lack of resources to pay for essential goods and services and the inadequate healthcare and other formal support programs for the older adults and their caregivers. This inadequate public policy coverage, rather than individual and intrafamily risk factors per se, needs to be considered as a significant cause of elder self-neglect/neglect.     

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.     

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.     

Substance abuse

Alcohol abuse poses special risks for increased morbidity and mortality among older adults, contributing to the heightened use of medical resources and the related increase in medical costs. Although the prevalance of alcohol use disorders in the older adults is generally less than that found in younger groups, it is expected to increase with the aging of the "baby-boom" generation. In spite of this, little attention has focused on developing, and evaluating the efficacy of, treatment programs for older adults with alcohol related disorders. This article discusses the availability of effective treatment strategies for older alcohol abusers and reviews the epidemiological and outcomes research literatures related to alcohol abuse and older adults. The few empirical studies that examine outcomes associated with the treatment of older substance abusers reveal positive outcomes, especially when "age-specific," cognitive-behavioral, and less confrontational treatment approaches are employed.     

Resilience among older caregivers in rural Namibia: The role of financial status,social support and health

Background: Namibia has one of the highest human immunodeficiency virus (HIV) prevalence rates and one of the highest rates of orphanhood in the world, and older caregivers provide much of the care to Namibians living with HIV and acquired immune deficiency syndrome (AIDS) (UNAIDS, 2014). In this study, the authors explore how financial status, social support, and health were related to the resilience of caregivers caring for people affected by HIV and AIDS in rural northern Namibia, Africa. Method: Data were collected through a structured interview from (N = 147) caregivers from the Zambezi region. Results: Findings from this study show that employment and physical health were significantly associated with increased resilience in older caregivers. Discussion: Our findings point to the need for employment assistance and health services to improve the resilience of caregivers caring for people living with HIV and AIDS. We conclude that there is a need for more vigorous concerted efforts from public and private sector practitioners and policy makers to create more sustained formal employment opportunities and intervention programs aimed at improving the overall health of older HIV caregivers, especially those residing in rural HIV endemic communities in developing countries.     

Old Age and Widowhood: Issues of Personal Control and Independence

This paper explores the interaction between the circumstances of old age and the demands of adjusting to widowhood. Most widowed individuals, especially women, have much of their life still before them. Three themes are developed: The implications of widowhood for successful aging, the utility of viewing the rest of one's life as a "career" to be planfully and actively pursued, and the increasing amount of heterogeneity among the elderly. These themes are related to issues of personal control and continued independence in old age.     

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.     

Religion and coping in older adults: a social work perspective

Religion is an important coping resource for many older adults. This paper briefly describes social work's religious roots, makes a distinction between religion and spirituality for older adults, and presents empirical data showing how older adults employ religious strategies to cope with life challenge. The study reports on religious coping in an available sample of 79 European American and African American older adults residing in urban community dwellings. Implications suggest how social workers and others may support religious coping.     

Creating elder-friendly communities: preparations for an aging society

Because many communities where older people live were not designed for their needs, older residents may require support to remain in the least restrictive environment. "Age-prepared communities" utilize community planning and advocacy to foster aging in place. "Elder-friendly communities" are places that actively involve, value, and support older adults, both active and frail, with infrastructure and services that effectively accommodate their changing needs. This paper presents an analysis of the literature and results of a Delphi study identifying the most important characteristics of an elder-friendly community: accessible and affordable transportation, housing, health care, safety, and community involvement opportunities. We also highlight innovative programs and identify how social workers can be instrumental in developing elder-friendly communities.     

Motivation to volunteer among senior center participants

Senior centers in the United States play a vital role in the aging continuum of care as the focal points of a community-based system of services targeting independent older adults to promote their social integration and civically engagement. Although several studies have evaluated the diversity of senior center programs, demographic characteristics of participants, and benefits of participation, very few have explored motivations to volunteer among participants. Many senior centers rely on a cadre of participants who volunteer there to assist with programs and meal services. However, a systematic examination of volunteering interests and the rationale for volunteering among senior center participants has been missing from the literature. This mixed-methods study, conducted at a large suburban senior center, explores the interests and motivations of volunteerism among the participants. The study found that there was limited interest in volunteering among senior center participants. Those who were motivated to volunteer wanted to do so in order to stay connected with their community. There was strong interest in volunteering for single events or projects rather than a long-term commitment. Implications for senior centers are discussed.     

Universal basic income: A feasible alternative to move people out of poverty in Mexico?

This paper evaluates the effectiveness of social policy to alleviate poverty in Mexico; where poverty is persistent, social programs are numerous and complex to monitor. Our analysis uses MEXMOD tax-benefit microsimulation. We simulate four scenarios that grant direct money transfers to individuals in multidimensional poverty, elderly people, families with children under 15 years old, and a universal basic income. The more generous and broader the coverage is, the costlier the policies. The first-best policy is the universal basic income, which can eradicate extreme poverty at the cost of 10.61 % of the gross domestic product. The least effective policy transfers only to older people.     

Conservatorship:

The term "protective services" for older adults has often implied the complete faking over of an impaired elderly person's life. In the past, the only way to protect an even partially impaired elderly person was to have him or her judicially declared incompetent. This was frequently followed by institutionalization. The social work profession's commitment to preserving as much of the client's right to self-determination as possible has made practicioners reluctant to pursue this course of action. Conservatorship, the authors believe, is a viable alternative to this.