Social Support,Retirement Resources,and the Gendered Experiences of Aging for Tunisian Older Adults

Cultural context plays an important role in the experience of aging. The country of Tunisia is of particular interest because limited studies on aging have been done in the past decade. The study examined data collected from Tunisian older adults in an attempt to gain additional information about their experience aging in this culture. The purpose of this study was to identify key information tied to social policy factors that have the potential to impact older adults living in Tunisia. From June to July 2017, semi-structured interviews were completed with 60 older adults covering topics about family history, daily activities, health and health satisfaction, retirement benefits and satisfaction, medical coverage, social support, service availability, feelings of growing older, as well as advice provided to younger adults. Findings include gender differences in retirement resources and benefits, sources of support, and older adults’ self-reported desires for the future. This work adds to the growing body of literature concerning differences in global aging and provides greater awareness of aging in the distinctive context of Tunisia. Additional work should seek to deepen the investigation of the various social policies that impact the Tunisian older adult.     

Global Social Justice for Older People: The Case for an International Convention on the Rights of Older People

Older people are beginning to represent a large proportion ofthe general population and have become a major area for socialprogramming in many parts of the world. However, neglect orviolation of older people’s rights is common. Until recently,there has been a surprising lack of advocacy on the part ofnon-governmental organizations (NGOs) and human rights activistsfor a legally effective international convention on the rightsof older people, as compared with other vulnerable groups suchas children and women. This paper argues that the introductionof an international convention on the rights of older peopleis long overdue. Such an international convention should containcomprehensive and legally binding provisions which would requireratifying states to promote older people’s rights. Itshould be reinforced by a strong monitoring system that wouldinvolve key members of the international community. This paperoutlines the arguments in favor of the creation of a transnationalhuman rights agreement for older people and proposes that internationalNGOs and human rights advocates should work toward creatingsuch a convention.     

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.     

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.     

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.     

Family Caregiving and the Site of Care: Four Narratives About End-of-Life Care for Individuals with Dementia

Little is known about end-of-life care for individuals with Alzheimer’s disease and other dementias. Four case studies are presented, using data collected by qualitative interviews conducted with family caregivers who were closely involved with end-of-life care for relatives with dementia. The case studies are formatted in two pairs, with one reflecting two deaths occurring at home and the other pair representing two deaths in the nursing home. The cases reveal a range of end-of-life experiences, suggesting that there is not just one “good” path. The extent of care needed, the responsiveness of the individual, the health of the caregiver(s), and the residence and support situations, can all intersect in a variety of ways that make no one scenario the answer for all. Although most people say they would prefer to die at home, in some situations the nursing home can be a satisfactory choice, particularly if hospice is involved. These narrative case studies give the reader insight into the variety of the end-of-life experiences and suggest the environment should be considered as part of the care provision.     

Trauma and Stress Among Older Adults in the Criminal Justice System: A Review of the Literature with Implications for Social Work

The purpose of this article was to review the empirical literature that investigated trauma and stress among older adults in the criminal justice system. Nineteen journal articles published between 1988 and 2010 were identified and extracted via research databases and included mixed age samples of adjudicated older and younger adults (n = 11) or older adult only samples (n = 8). Findings revealed past and current trauma and stress, consequences and/or correlates, and internal and external coping resources among aging offenders. The implications and future directions for gerontological social work, research, and policy with older adults in the criminal justice system are advanced.     

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.     

Social Insurance and Older Adults in China: Effect of Education and Household Income on Coverage Following the 2009 Health Reform

Abstract

Education and income have been considered two primary determinants to affect individuals’ health outcomes. China initiated a comprehensive health reform in 2009, with the goals to provide equal access yet sufficient healthcare to all residents. However, social disparities continue to persist following this large reform. This research hypothesized that older adults’ years of education and income are determinants of participation in each social insurance scheme following the 2009 health reform. Multilevel logistic regression models were used with a nationally representative sample (n?=?5,274) to investigate the education and income disparities in each social insurance scheme for older adults, with random effects among provinces at the national level. The analyses show that years of education was not associated with enrollment in three social insurances, with the exception of the association between 11?years of formal education or above and the rural coverage. Participants with higher levels of household income had greater odds of having urban social insurances, but had lower odds of having the rural scheme. Further research should continue to investigate the disparities of enrollment of each social insurance. Chinese policy makers should consider these social factors carefully to reach a true universal coverage.     

Older Carers of Adults with a Learning Disability Confront the Future: Issues and Preferences in Planning

The Valuing People White Paper (Department of Health, 2001)requires services to secure a plan for all service-users withlearning disabilities living with older carers and promisesthem and their families more choice and control over how andwhere they live. This paper examines the views of the oldercarers (aged over seventy) of sixty-two adults with a learningdisability about planning for the future. Fifty-six took partin interviews in their own homes and six completed a questionnaire.All carers were white and recruited from one local authorityin response to the requirements of the White Paper. Findingsindicate that a significant proportion (thirty-four—55per cent) is either not ready or is unwilling to make futureplans. Barriers to planning include a perceived lack of needdue to the existence of two carers, a lack of awareness of timescalesinvolved in securing housing, difficulties in letting go, alack of confidence in available housing options, and the existenceof mutually supportive relationships. The findings show a needfor a proactive approach to information and support provisionto enable these families to work through a process of makingplans for the future. This is essential to prevent the needfor emergency placements in response to crisis and in turn toensure that adults with learning disabilities have genuine choiceand involvement in how and where they live.     

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.     

Changes in Life Satisfaction Among Participants of Adult Day Care and Their Informal Caregivers

This paper examines changes in life satisfaction among participants of Adult Day Care (ADC) in Manitoba, Canada, and their informal caregivers (where applicable). ADC participants (N = 112) and their informal caregivers (N = 34) were interviewed at two points in time. Data analyses reveal that, during attendance at the program, the life satisfaction of both the participant and the informal caregiver tend to improve. Attempts to predict which participants are most likely to improve, remain stable, or deteriorate in life satisfaction were largely unsuccessful. A smaller group of participants in Winnipeg programs were matched on age, sex, functional disability and illness with two control groups. Analyses reveal improvements in life satisfaction among ADC participants appear to be program effects.     

Supporting the Labor Force Participation of Older Adults: An International Survey of Policy Options

The unprecedented aging of the world's population challenges many institutions, including labor markets and public pension programs. This study was conducted to survey expert opinions regarding conditions and policies that affect employment of older adults. Eighty-nine respondents from 26 nations responded to an Internet survey regarding their own experiences with the aging labor force; factors that encouraged or discouraged labor force participation of older adults; and government responses to these issues. Respondents identified barriers to employment of older adults and described their governments' responses. Findings illuminate a range of current policy options and suggest possible opportunities for innovation.     

Social Support and its Correlation with Loneliness and Subjective Well-being: A Cross-cultural Study of Older Nepalese Adults

Population aging in Nepal is a recent phenomenon, due more to demographic changes than to socio-economic development. The study had three goals: to analyze the social support exchange among elderly men and women; to discover the main sources of support in loneliness and subjective well-being in the elderly; and to study the cross-cultural differences in support among elderly Chhetri ( N  = 137, mean age = 69.1 [7.2] years) and Newar people ( N  = 195, mean age = 68.8 [7.7] years) in one ward in Kathmandu. The data were collected using face-to-face interviews. The dependent variables were loneliness and subjective well-being (SWB). The results for both ethnic Chhetri and Newar respondents show that their major support comes from their children living in the same household and their spouses. I conclude that the sources of social support and social support exchange are similar between the two castes/ethnicities and that there are no cross-cultural differences between them in terms of support for loneliness and SWB-life stability, although there are cross-cultural differences in their SWB-life satisfaction. Providing social support to friends and neighbors appears to be related to less loneliness and increased SWB in both castes/ethnicities.     

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.     

Family and community support among older Chilean adults: the importance of heterogeneous social support sources for quality of life

Family and community social networks act as social resources that promote well-being at advanced ages. In this study, we analyze the association between social support received from personal social networks (social support from various family members and friends) and community social networks (social support from neighbors and the neighborhood, age, ethnic, or religious group peers and formal social support networks) and quality of life (QoL) for a sample of older Chilean persons (n = 777). The results confirm that social support from family (partner, children, and extended family) and friends, integration in the community (neighbors) and social support from informal systems (social groups) are associated with QoL. Moreover, the model including both types of support explains 25.8% of variance in QoL. The results and their possible implications are discussed.     

The Development of Korea's New Long-Term Care Service Infrastructure and Its Results: Focusing on the Market-Friendly Policy Used for Expansion of the Numbers of Service Providers and Personal Care Workers

One of the main reasons for reforming long-term care systems is a deficient existing service infrastructure for the elderly. This article provides an overview of why and how the Korean government expanded long-term care infrastructure through the introduction of a new compulsory insurance system, with a particular focus on the market-friendly policies used to expand the infrastructure. Then, the positive results of the expansion of the long-term care infrastructure and the challenges that have emerged are examined. Finally, it is argued that the Korean government should actively implement a range of practical policies and interventions within the new system.     

Workplace Flexibility as an Organizational Response to the Aging of the Workforce: A Comparison of Nonprofit and For-Profit Organizations

ABSTRACT

The degree to which flexible work options are available to employees has been used as an indicator of the extent to which organizations have responded to workforce needs, including those related to the aging of the workforce. This article uses an organizational adaptation framework to determine factors that explain variation in the degree to which flexible work options are offered in for-profit and non-profit organizations. Findings indicate that while the scope of flexible work options offered was similar among for-profits and non-profits, the factors that predicted variance in the scope of these options differed somewhat between the two sectors.     

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.     

Aging,Depression, and Wisdom: A Pilot Study of Life-Review Intervention and PTSD Treatment With Two Groups of Vietnam Veterans

Vietnam War veterans are a sometimes overlooked subgroup of the aging baby boomer generation. Forty years after the war ended, war veterans still seek out VA or Vet Center counselors to assist with traumatic stress symptoms. However, there currently are no specific age-related protocols for treating older war veterans suffering from posttraumatic stress disorder (PTSD), nor have established PTSD interventions incorporated gerontology content for these older trauma survivors. This pilot study juxtaposed life review within regular PTSD group counseling for 12 Vietnam veterans at a community-based Vet Center using a partial crossover design. The Life Review and Experiencing Form (LREF) structured the delivery of the life review component. T-tests and repeated measures ANOVA were used to examine depression and self-assessed wisdom outcomes using measures previously tested with older adults. Findings suggest that life review prior to PTSD group therapy has clinical benefits for reducing symptoms of depression and increasing self-assessed wisdom. The study illuminates the possible relationship of traumatic stress symptom effects on the natural reminiscing process for older veterans and provides insights into methods for more age-appropriate treatment for trauma survivors participating in Vet Center and VA programs nationwide.