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.     

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.     

Perceptions of preparedness to assist elders with end-of-life care preferences

Using a systematic sample of Florida licensed clinical social workers (N = 272), this study found that respondents perceived themselves capable of assisting elders with end-of-life care decisions and considered themselves moderately knowledgeable of resources available to elder clients. Respondents indicated slightly positive attitudes for work with elders and elders with Alzheimer's disease, and most respondents believed that elders should have the right of physician-assisted suicide. Using multivariate analysis, four predictor variables were identified that account for 61.3% of the adjusted variance of the dependent variable of preparedness to assist elders with end-of-life care preferences. These predictor variables were (a) knowledge of resources available to elders, (b) desirability of working with elders, (c) desirability of working with elders with Alzheimer's disease, and (d) attitude toward assisted suicide.     

Perceptions of Preparedness to Assist Elders with End-of-Life Care Preferences

Abstract

Using a systematic sample of Florida licensed clinical social workers (N = 272), this study found that respondents perceived themselves capable of assisting elders with end-of-life care decisions and considered themselves moderately knowledgeable of resources available to elder clients. Respondents indicated slightly positive attitudes for work with elders and elders with Alzheimer's disease, and most respondents believed that elders should have the right of physician-assisted suicide. Using multivariate analysis, four predictor variables were identified that account for 61.3% of the adjusted variance of the dependent variable of preparedness to assist elders with end-of-life care preferences. These predictor variables were (a) knowledge of resources available to elders, (b) desirability of working with elders, (c) desirability of working with elders with Alzheimer's disease, and (d) attitude toward assisted suicide.     

Providing mental health services to older people living in rural communities

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 wellbeing 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.     

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.     

Family Support and Health Status of the Elderly in Imo State of Nigeria

This article highlights ageing issues in a community in a developing African nation. This exploratory study uses quantitative and qualitative methods. Seventy–five elders were sampled from Imo State, Nigeria. Results indicate that family support is potentially available at a ratio of 3 to 1 with most of the elderly depending on their children, wives, in–laws,and God. The elderly express satisfaction with family care and they rarely live alone. The elders attach greater value to non–material (physical presence/emotional) support. The most prevalent acute and chronic illnesses of the elderly are respectively malaria, followed by severe headache, flu, sleeping problems; and rheumatism/arthritis, followed by failing vision, general weakness and hip problems. The implications of these findings for policy are considered.     

Race and income disparities in disaster preparedness in old age

ABSTRACT

This study investigated to what extent income status and race/ethnicity in old age interplayed with disaster preparedness. Data came from the 2010 Health and Retirement Study, a nationally representative panel survey of older Americans over 51 years old. Our sample was restricted to respondents who participated in a special survey about disaster preparedness (N=1,711). Disaster preparedness was measured as a score, which includes 13 variables. Race/ethnicity was categorized by White, Black, and Hispanic. Low income was defined as below 300% of the federal poverty line. OLS regression was used to examine the main and interaction effects of race/ethnicity and lower income status on disaster preparedness scores. We found that older adults in lower income status had lower preparedness level than those in higher income (Coef. =-0.318, p<.01). Hispanics tend to be less prepared compared to White and Blacks (Coef. =-0.608, p<.001). Preparedness of Black elders was not significantly different from that of Whites. However, interestingly, Black elders in lower income status were significantly less prepared for disaster than other groups (Coef. =- 0.622, p<.05). This study identified vulnerable subgroups of older adults for disaster preparedness and suggests that preparedness programs should target minority and low income elders.     

高龄化视野下医疗资源分配的公正性研究

考虑到严峻的高龄化形势,20世纪中期以美国为首的发达国家开始审视医疗这一稀缺资源在社会不同年龄群体之间分配的公正性问题。功利主义指导下的年龄标准模型因主张限制向高龄群体分配医疗资源而饱受伦理与法律争议。在机会平等主义学者的推动下, Medicare最终确立了医疗资源应该向高龄人口倾斜的分配模式,从实质上确保了其获取医疗服务的平等性,保障了医疗资源的公正分配。     

Factors associated with loneliness among the institutionalised elders in Shanghai,China: the role of social support

Studies have shown that loneliness is increasingly prevalent among the aged, especially those who live in institutions. This study examines the role of social support and differences in loneliness among institutionalised elders, using a face-to-face questionnaire interview in a Shanghai institution. Results show that the prevalence of loneliness among participants was relatively high. Gender, subjective appraisals of relationship with nurses, frequency of being visited by children, frequency of being visited by friends, and subjective appraisals of relationship with roommates were significant predictors of loneliness. The quality of social support was indicated as a significant factor for predicting loneliness rather than its quantity. It is striking that frequency of being visited by children was found to be positively associated with loneliness. This counterintuitive finding suggests that the function of family for those institutionalized elders may be negative under China’s cultural norms, beliefs, and perceptions, which is incongruent with theoretical assumptions in Western countries.     

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.     

Barriers to the Use of Mental Health Services by African-American and Hispanic Elderly Persons

Abstract

This study discusses barriers to the utilization of community-based mental health services by African-American and Hispanic elderly persons. The study sample consists of “key Informants,” chosen because they were knowledgeable about the mental health needs and use of mental health services by African-American or Hispanic elderly persons. Principal component analysis using orthogonal rotation was conducted on the 23 item barrier scale and identified three levels of service barriers for the entire sample and for each subsample of African-American and Hispanic informants. Based upon the study findings, a number of strategies are offered to improve Utilization and overcome service delivery barriers.     

Life values,family support and psychosocial adaptation among older people in Taiwan: an institutional and community comparison

The purpose of this study was to investigate the psychosocial adaptation among elderly persons in institutional and community settings, and to explore factors influencing their adaptation. A cross-sectional survey was conducted with a convenience sample of 165 residents of four institutions (two assisted-living facilities and two nursing homes) and 209 community-dwelling elders served by a primary care centre, all located in middle Taiwan. A structured interview questionnaire was used to collect data. Results: community-dwelling elderly had significantly higher adaptation scores than those in institutional settings. Factors related to adaptation differed between institutional and community settings, with more variables influencing adaptation in the community than in the institution. Physical functional status was the major influence on adaptation of the elderly in institutions. Dietary support from family was negatively associated with adaptation in this group. Influencing factors for community-dwelling elders were more complicated, including perceived family emotional and economic support, personal life values and physical functional status. Implications: greater support from government, including economic resources and assistance in community care are needed to achieve the policy goal of ‘aging in place’. Further investigation of the influence of family interaction on elders' adaptation is needed.     

Depression and social networks in community dwelling elders: a descriptive study

Social isolation and inadequate social support have been identified as correlates of depression in older adults, although the relationship between depression and social isolation is not entirely understood (Dorfman et al., 1995). This study was conducted to describe the social networks of depressed older adults living in the community and to compare the social networks of depressed and nondepressed individuals, thus adding to the body of knowledge regarding social networks, older adults, and depression. The sample consisted of 91 respondents aged 65 and older who were randomly selected using the voter registry. About 27% (25) respondents reported significant levels of depressive symptomology as measured by the Center for Epidemiological Studies-Depression Scale (CES-D). All respondents completed semistructured interviews that included questions about social contacts with family and others during the prior week. All participants reported social contact with family and friends during this period. In this sample, depressed elders were not socially isolated. They were more likely to report contacts with friends than those who were not depressed, and equally likely to report involvement in volunteer activities. Their likelihood of seeking social support was also comparable. Results emphasize the importance of peer relationships and suggest that, in some groups of older adults, social isolation may not be a hallmark of depressive symptoms.     

Depression and Social Networks in Community Dwelling Elders: A Descriptive Study

Social isolation and inadequate social support have been identified as correlates of depression in older adults, although the relationship between depression and social isolation is not entirely understood (Dorfman et al., 1995). This study was conducted to describe the social networks of depressed older adults living in the community and to compare the social networks of depressed and nondepressed individuals, thus adding to the body of knowledge regarding social networks, older adults, and depression.

The sample consisted of 91 respondents aged 65 and older who were randomly selected using the voter registry. About 27% (25) respondents reported significant levels of depressive symptomology as measured by the Center for Epidemiological Studies-Depression Scale (CES-D). All respondents completed semistructured interviews that included questions about social contacts with family and others during the prior week. All participants reported social contact with family and friends during this period.

In this sample, depressed elders were not socially isolated. They were more likely to report contacts with friends than those who were not depressed, and equally likely to report involvement in volunteer activities. Their likelihood of seeking social support was also comparable. Results emphasize the importance of peer relationships and suggest that, in some groups of older adults, social isolation may not be a hallmark of depressive symptoms.     

何时方休?——中国老年人就业参与的队列分析

推迟退休年龄是应对人口老龄化的重要措施.利用第六次人口普查汇总数据,以40岁为年龄起点分析从中年到老年就业参与状况,并结合"五普"数据运用队列分析方法探讨老年人口就业状况的变化轨迹.结果显示,在法定退休年龄处,人口在业比例有一个明显的下降梯度,但法定退休年龄对老年群体的就业行为影响程度存在明显的城乡差异.城镇人口在业比例在50-60岁间明显下降,而农村人口在业比例下降则发生在60岁以后.此外,在业老年人口中超过80%为农村老年劳动力.虽然当前在农村地区并未实行退休制度,但农村养老金的发放以退休年龄为起点,因此,在调整退休年龄时需要特别关注农村老人,避免养老金的延迟发放使其陷入贫困和老无所依.     

Contributing Factors of Depressive Symptoms Among Elderly Korean Immigrants in Texas

This study examined various life stresses associated with relocation that may contribute to depressive symptoms among Korean immigrant elders in Texas. A sample of 120 elders was assessed using the Geriatric Depression Scale–Short Form and a 90-min face-to-face interview. Over 1/3 of respondents (37.5%) had symptoms of depression. Regression analyses (R² = .331) indicate that self-rated health, stressful life events, English language proficiency, satisfaction of visiting one's birth place, and watching TV were correlates of depressive symptoms among them. The findings of this observational study may be used as a baseline for designing service program for this population.     

Depression Among Korean Immigrant Elders Living in Canada and the United States: A Comparative Study

Korean immigrant elders in North America experience a high level of depression. This study explored the correlates of depression among a sample of 245 Korean immigrant elders living in metropolitan cities in Canada (n = 128) and a southwestern state in the United States (n = 117), using a stress-coping framework. Results revealed discrepancies between the 2 subgroups. Years since immigration and number of health concerns were positively associated, and English proficiency was negatively associated with depressive symptoms among Korean immigrant elders in the United States; only health status was significant among Korean immigrant elders in Canada. Implications of the study are presented.     

Coordinating County Based Services for the Frail Elderly

The aging network is fraught with fragmentation. Services to the elderly are administered out of multiple agencies and departments at all levels of government. This article discusses the approach taken by one county to diminish the level of fragmentation to frail elders by a cooperative agreement between key county departments providing services to the aged.