Civic Engagement for Nursing Home Residents: A Call for Social Work Action

Civic engagement has been found to be associated with a number of emotional and physical benefits for older adults. For those residing in nursing homes, however, opportunities for civic engagement are limited. Societal barriers such as ageism and practical issues such as transportation can limit their access to activities that promote civic engagement. In this article, we review past research on civic engagement for older adults and explore the challenges and barriers faced by nursing home residents. We conclude with a call for social work professionals to develop, implement, and evaluate interventions that increase civic engagement opportunities for this undervalued group.     

A Multilevel Analysis of Aggressive Behaviors Among Nursing Home Residents

Individual and organizational characteristics associated with aggressive behavior among nursing home residents were examined among a sample of 5,494 residents from 23 facilities using the Minimum Data Set 2.0 and the Organizational Social Context scale. On admission, some individual level variables (age, sex, depression, activities of daily life [ADL] impairments, and cognitive impairments) and no organizational level variables were associated with aggressive behaviors. Over time, aggressive behaviors were linked with some individual characteristics (age, sex, and ADL impairments) and several organizational level variables (stressful climates, less rigid cultures, more resistant cultures, geographic location, facility size and staffing patterns). Findings suggest multi-faceted change strategies are needed.     

The Family Group Within the Nursing Home:

An ongoing monthly family group was implemented in an intermediate care facility in hopes of improving communication between staff and families of long term care residents. Other objectives of the group were to provide families with information about policies and procedures, education about the aging process, and to facilitate an informal support group network where families could share problems and concerns. The feedback and evaluation process indicated that sharing feelings of anger, quiet, frustration and other emotions helped the families deal with the responsibilities of institutionalizing a relative and helped to facilitate better communication between staff and family members.     

Understanding the Impact of Early-Life Trauma in Nursing Home Residents

Reactions to early life trauma can reemerge or be exacerbated in later life as coping resources and abilities are compromised by age-related changes and declines in health. For newly admitted nursing home residents, this can impact their receptiveness to assistance with care and elicit challenging reactions to environmental and situational triggers. Unfortunately, current assessment tools fail to account for reactions to early-life trauma. In this article, we review existing literature on early-life trauma and aging and introduce a hypothetical case to illustrate the importance of identifying nursing home residents with past trauma experiences.     

Unmet Home Care Service Needs of Rural Older Adults With Alzheimer's Disease: A Perspective of Informal Caregivers

This study assessed unmet service needs of rural older adults with Alzheimer's disease (AD) and identified factors that were related to these needs. Data were collected from 109 informal caregivers of AD patients. Over half of the patients experienced unmet service needs in 1 or more areas of activities of daily functioning. Informal caregiver burden and patient's gender and functional status were significantly related to patients' unmet service needs. Patients' use of formal services was marginally related to their unmet service needs. To better address patients' service needs, a comprehensive needs assessment should be conducted with both patients and their caregivers.     

“A game of two halves?” Understanding the process and outcomes of English care home closures: Qualitative and quantitative perspectives

With care services increasingly delivered via a market there is always a risk that care homes could fail financially or struggle in terms of quality, ultimately having to close. When this happens, the received wisdom is that subsequent relocation can be detrimental to the health and well‐being of older residents (possibly even culminating in increased mortality). However, there is very little formal evidence in the United Kingdom (UK) or beyond to guide policymakers and local leaders when undertaking such sensitive work. Against this background, this article reports findings from an independent evaluation of what is believed to be the largest care home closure program in the UK (and possibly beyond). This consisted of qualitative interviews with older people, families, care staff, and social work assessors during the closure process in one case study care home and one linked day center, as well as self‐reported health and quality of life data for older people from 13 homes/linked day centers at initial assessment, 28 days after moving and at 12‐month follow up. The study is significant in presenting public data about such a contested topic from such a large‐scale closure process, in its focus on both process and outcomes, in its mixed‐methods approach, and in its engagement with older people, families, and care staff alongside the use of more formal outcome measures. Despite significant distress part‐way through the process, the article suggests that outcomes either stayed the same or improved for most of our sample up to a year after moving to new services. Care homes closures may thus be a “tale of two halves”, with inevitable distress during the closure but, if done well, with scope for improved outcomes for some people in the longer term. These findings are crucial for current policy and practice given that the risk of major closures seems to be growing and given that there is virtually no prior research on which to base local or national closure processes. While some of this research is specific to England, the underlying issue of care home closures and lessons learned around good practice will also apply to other countries.     

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     

Decoding the Miss Daisy Syndrome: An Examination of Subjective Responses to Mobility Change

The subjective responses associated with personal life space and mobility status were explored. Thirty individuals participated in focus groups based on self-rated disability status, current places visited, and availability. Qualitative analyses revealed that most participants equated personal mobility with driving a vehicle. Attitudes concerning mobility status and preparedness for change varied based on disability level and personal experience. Fear of dependence from future mobility loss was prominent in all groups. Few participants acknowledged significant planning for future retirement from driving or other mobility challenges. An understanding of common attitudes, perceptions and meanings can inform professionals who intervene and support older adults experiencing mobility changes.     

Contributions of Volunteer Networking to Isolated Seniors in Hong Kong

Abstract

Although research and theory suggest that volunteers contribute to the quality of life of senior people whom they serve, rigorous empirical investigation is missing for senior Hong Kong Chinese. A project that recruits, trains, and matches volunteers for isolated and frail senior Hong Kong Chinese is good for the investigation because it represents a new approach. This study employed a two-wave panel design to collect data from 125 users of the volunteer networking project. Its results demonstrate that volunteer input, in terms of contact intensity and helpfulness, significantly contributed to Wave 2 quality-of-life outcomes, including reduction in worry, increase in community knowledge, and social integration given the control of their prior scores. Nevertheless, volunteer input had no significant effects on the senior visitee's health.     

Care leaver needs and accessibility: Findings from the first large‐scale project in Switzerland

Leaving out‐of‐home care is a challenging situation not only for young people leaving care but also for the child welfare system. However, systematic and multiorganizational transitional programmes are often lacking. This study investigated Switzerland's first large‐scale care leaver programme and analysed associations between care leavers' needs and contactability in a sample of 459 care leavers. A first track compared the characteristics of successfully contacted care leavers and of not contactable care leavers (‘dropouts’). The second track analysed the association between need for support and self‐rated or proxy‐rated quality of life in the subsample of 235 successfully contacted care leavers. Odds for indicators of lower educational attainment were substantially increased for dropouts. Additionally, self‐reported need for support was significantly associated with lower self‐ratings of quality of life in seven areas. Care leavers who accepted the programme's offer of coaching rated their quality of life lower than participants who reported no need for support and participants who reported a need for support but turned down coaching. For successfully contacted care leavers, the programme gave access to coaching sessions to the young people the most in need. However, dropouts appeared more vulnerable and might therefore benefit even more from aftercare support.     

A Comparison of Rural and Urban Older Adults in Iowa on Specific Markers of Successful Aging

This study examines the differences between rural and urban older adults on level of life satisfaction and depressive symptoms, focusing on the effect of social support. Data were collected through structured interviews at senior centers and senior meal sites in eastern and southeastern Iowa. The Duke Social Support Index (DSSI), the Life Satisfaction Index-Z (LSI-Z), and the Geriatric Depression Scale 15 (GDS15) were used. Correlations (Pearson's r), independent sample t-tests, and multiple regression were computed. Findings indicated that urban residents reported more depressive symptoms, as compared to rural residents. Subjective level of social support was a stronger predictor of life satisfaction and was more negatively related to depressive symptoms among rural than among urban older adults. Results suggest that social workers who work with aging people need to be aware of rural–urban differences in mental health. Furthermore, social workers need to have knowledge of older adults' social networks and work to ensure greater opportunity for social interaction.     

The Role of the Social Worker in Long-Term Care

Abstract

Making use of a formulation by Rosalie Kane of the ingredients necessary to “a good life” for residents of homes for the aged and other long term care facilities, the role of the social worker in insuring the presence of these ingredients is discussed. Included is an analysis of the responsibilities and tasks of the social worker which must be carried and fulfilled in order that social workers make appropriate contributions to “the good life.”     

"唯务折衷":《文心雕龙》文论思想的文化品格

本文提出并论证"唯务折衷"是<文心雕龙>文论思想独特的一种文化选择.其文论思想具有亦道亦儒亦佛又非道非儒非佛的趋于圆融的精神品格与人文内涵;其为学的观念、方法,体现了刘勰站在道儒佛之上俯瞰三学与古今的"弥纶群言"的精神气度、自创新格的努力以及兼顾两边又不落两边的执中.     

Evaluating the Roles of Professional Geriatric Care Managers in Maintaining the Quality of Life for Older Americans

This study examined the roles of Professional Geriatric Care Managers (PGCMs). In-depth telephone surveys were completed with 19 PGCMs. Qualitative data were coded independently by two researchers. PGCMs reported that most clients and/or families seek services in response to a health crisis or because a family member was providing care at a distance. Most emphasized the importance of treating clients as autonomous decision-makers. Services described as most useful were supporting families and caregivers, being an advocate for clients, conducting initial assessments and ongoing follow up, and educating families about community resources and the financing of long term care. Regarding maintaining the quality of life for their older clients, a number of care managers described assisting clients to live independently at home, arranging for transfer to an appropriate level of care, and helping clients die peacefully with dignity. Major challenges PGCMs encountered were family conflicts and obtaining needed services. Recommendations to improve PGCM practice include increasing awareness of services, and establishing minimum professional standards through certification.     

明朝后妃在皇位继承危机中的作用

在明朝屡次发生的皇位继承危机中,后妃发挥了重要的作用。但少数后妃在皇位继承危机中也起了消极作用,亦对明朝政局产生了负面影响。从总体看,在明朝出现皇位继承危机时,后妃的积极作用还是主要的,这对明朝近三百年统治中,保持较长时间的社会稳定和经济发展,是非常有利的,应予以肯定。明朝后妃之所以能在皇位承继中发挥积极作用,其原因在于高度集权的君主专制和明朝皇帝昏庸腐化者居多的实际状况。     

先秦诸子的廉政思想及其现代价值初探

先秦诸子的廉政思想产生于先秦社会转型时期。尽管由于学派不同 ,但各派对廉政的认识几乎是趋于一致的。廉政必须解决好爱民、举贤和法治等问题 ,这是先秦诸子的一致共识。这些思想不仅在当时达到了相当水平 ,而且在今天也仍然具有重要的现代价值     

唐代文人与隐士交游的动因

隐逸风尚的盛行 ,使唐代文人与隐士的交游十分密切 ,这一独特的文化现象在唐诗中得到集中的反映。这一现象的产生 ,主要是基于对隐士学识修养的敬服、道德人格的敬慕、恬逸生活情趣的企羡     

唐代郊庙歌辞语境下的祭礼分析

郊庙歌辞,系古代帝王祭祀天地、宗庙、明堂、社稷等大典时所用的歌辞,是一种集诗歌、音乐、舞蹈于一体的综合艺术形式。以祭祀活动作为创作出发点的郊庙歌辞,在内容上重在描述和表现人与天地、鬼神之交往、沟通,其敬天、亲人的内在精神与祭祀本身的内涵是相一致的。