Geriatric Hospitals in India,Today and in the Future

Summary

In a country that shuns hospitalization of the elderly, regarding it as disrespect of those who helped youngsters evolve, Heritage Hospital (HH)is a welcome change, a model and pioneer stand-alone geriatric hospital. With its non-ambulatory services looking after sick elderly, HH is like an extended family of seniors. HH's love and fresh air complement its Meals-on-Wheels program, guided by the nutritionist's healthy food. HH's Volunteer Guild; its Diabetes Club, ever growing with India's dramatic rise in the number of diabetics; its Senior Net Club's Click@50, making elders computer savvy; and Grandparent-Grandchild and Golden and Silver Couple contests celebrated on October 1st, are all widely appreciated, enforcing strong values Indians still share on marriage and family. Heritage brings together 10,000 seniors in Hyderabad, strengthening its motto of Eastern philosophy with its strong emphasis on care for the elderly.     

Linking Elderly to Holistic Care Services through Integrated Communication Technology: The Personal Emergency Link Service Rendered by the Senior Citizen Home Safety Association in Hong Kong

Through a Personal Emergency Link system, the Senior Citizen Home Safety Association has rendered 24-hour care to more than 111,000 service users in Hong Kong who are mostly vulnerable seniors and chronic invalids living alone or living with their elderly spouses/caregivers only. This article will describe how the Personal Emergency Link system is used to link seniors living in the community. Measures taken to prevent failure of the system will be described. With the use of different technology applications, many human touches and warm caregiving are rendered to the elderly and needy.     

Older people in America's immigrant families: Dilemmas of dependence,integration, and isolation

Immigration to the US has given rise to a population of older people who migrate here to be close to their children. Although highly integrated into their intergenerational families, these seniors voice dissatisfaction with their lives in the US. Intensive interviews with 28 transnational seniors demonstrate that their dissatisfaction stems from the contradictions between high cultural expectations for family sociability and structural constraints on kin interaction in the US. Their dissatisfaction is exacerbated by factors isolating them from social contacts outside the family. Although mobility limitations and not speaking English contribute to their isolation, immigrant families play a role. Older people are sometimes isolated by heavy domestic responsibilities in their child's household, solicitous offspring who insulate parents from practical aspects of daily life, and by a collective family ethos that calls on aging parents to subordinate their needs to those of other family members.     

Toward Health Reform for Seniors in Bermuda: Historical Constraints on Political Possibilities

In 2009, as the United States moved toward health care reform, the government of Bermuda implemented its FutureCare program to make health care for seniors more affordable. This article investigates how preferences for reform and its eventual design were shaped by the country's social history and commitment to free market values. Data derive from 36 in-depth interviews with key stakeholders deemed knowledgeable about health care financing and delivery in Bermuda, including government officials, provider representatives, insurance executives, and consumer advocates. Data also derive from a variety of documentary sources. Results indicate that although a clear need for health care and the ability to finance it for seniors exists in Bermuda, the scope of reform was circumscribed by preferences for prior policy decisions, creating a favorable tax and business environment for international corporations and a minimalist social welfare state for addressing racial and economic inequality. This suggests that widespread agreement on the challenges in meeting the health and long-term care needs of the elderly does not necessarily lead to equally commensurable solutions to addressing it.     

Service Enriched Housing and the Senior Living Enhancement Program

ABSTRACT

The Senior Living Enhancement Program was an initiative designed to provide selected services to seniors, including nursing and health promotion, social service coordination, and social and recreational opportunities. The seniors were located at 12 high-rise buildings for the elderly. The main goal of the initiative was to improve the health of seniors in 10 areas called the 10-Keys to Healthy Aging. In general, the 10-Keys to Healthy Aging are strategies aimed at reducing preventable risk factors in the aging population. Over a period of 2 years, seniors showed improvements in a majority of the 10-Keys to Healthy Aging and, therefore, proved the health benefits for elders coming from this service-enriched housing initiative.     

Housing Concepts For and By the Elderly: From Subjects of Design to a Design Resource

ABSTRACT

The perception of elderly residents as a homogeneous group is challenged by the diversification of lifestyles and emphasis on individuality in housing. Recently, there has been a rise in Finland in housing projects initiated by groups of elderly people, where the seniors themselves are seeking to fill in qualitative gaps in the offering of housing. This article presents a comparative analysis of four senior housing concepts that represent both a producer-driven (“for the elderly”) and a resident-driven (“by the elderly”) approach. The study shows that elderly people can be a resource for residential development and that this necessitates a different “design logic” than in conventional senior housing.     

Toward health reform for seniors in Bermuda: historical constraints on political possibilities

In 2009, as the United States moved toward health care reform, the government of Bermuda implemented its FutureCare program to make health care for seniors more affordable. This article investigates how preferences for reform and its eventual design were shaped by the country's social history and commitment to free market values. Data derive from 36 in-depth interviews with key stakeholders deemed knowledgeable about health care financing and delivery in Bermuda, including government officials, provider representatives, insurance executives, and consumer advocates. Data also derive from a variety of documentary sources. Results indicate that although a clear need for health care and the ability to finance it for seniors exists in Bermuda, the scope of reform was circumscribed by preferences for prior policy decisions, creating a favorable tax and business environment for international corporations and a minimalist social welfare state for addressing racial and economic inequality. This suggests that widespread agreement on the challenges in meeting the health and long-term care needs of the elderly does not necessarily lead to equally commensurable solutions to addressing it.     

Engagement of the Elderly in Time Banking: The Potential for Social Capital Generation in an Aging Society

Community currency systems attempt to empower the economically marginalized and build social capital. This research explores the role of the elderly in a local voluntary organization. The elderly are potentially very important contributors, yet we know little about their participation in these local exchange networks. Eighty-seven months' worth of transaction data from a “time bank,” which has had a total of 950 members, was examined in social network analyses. Measures of quantitative engagement in the system were constructed. The elderly were found to be as active as other members. Qualitative characteristics of the network were also explored. The organization is rather homogeneous, yet exchanges within it tend to connect diverse actors. Male and female seniors undertransact with themselves and with one another, generating bridging social capital. The evidence presented suggests that the participation of the elderly in local currencies is mutually beneficial.     

Intergenerational Coresidence and Nearness in Korea and Japan: Unbalanced Aspects of Family Changes

Abstract  This study aims to explain similarity and difference in geographic proximity between elderly parents and their children in Korea and Japan. Using data sets from two nationally representative surveys conducted in Korea and Japan, this study examines the extent to which needs and kinship of elderly parents and regional constraints influence intergenerational coresidence and nearness.
Results highlight a complex feature of intergenerational relationship in Korea and Japan. Advanced economic and health conditions of Korean elderly parents increase the likelihood of living with children. For Japanese elderly parents, however, coresidence with children is significantly likely to occur in response to their disadvantaged economic status. These results suggest that the elderly Korean are more likely than the elderly Japanese to lack not only economic and health resources but also opportunities in obtaining family support in a time of need.
Characteristics of children, however, show a similar trend between the two societies. Both societies maintain a strong son preference for extended family living arrangement. Eldest children in both societies are more likely than their siblings to live with or near elderly parents. However, children of younger cohorts in both societies are significantly more likely than those of older cohorts to maintain a disperse geographic network indicating a significant change in family attitude among different cohorts.
Finally, this study finds a more disperse family network among rural elderly parents than urban elderly parents in both societies reflecting the fact that massive rural-to-urban migration of young population has contributed to geographic segregation of kinship in these societies.     

Family Caregivers for Seniors in Rural Areas

In this article, the demographic characteristics of family caregivers for seniors in rural communities are assessed to examine whether their circumstances could facilitate or impede their well-being. Services available in rural communities for family members providing ongoing care to frail seniors is examined, particularly those that provide health and social services. How families access these services and whether there are specific barriers in service provision are analyzed based on current social work practice and the research literature. Trends for future services are identified as well as whether these trends support new roles for social workers in rural settings.     

Who Plays Bingo in Later Life? The Sedentary Lifestyles of ‘Little Old Ladies’

Abstract Bingo is a popular past time with less than 20% of seniors, but the prevailing stereotype of bingo players describes elderly women with nothing better to do, smoking heavily while gambling away their limited income day after day. Little research has actually explored the lifestyles of seniors who frequent the bingo halls or identified social factors explaining who plays and why. Purpose The purpose of this study was to clarify the social context and lifestyle characteristics of seniors who regularly invest money on bingo. Design and Methods A 30-min telephone survey was conducted randomly with quotas for gender and urban/rural location with 400 Albertans aged 65+. Next, a strategic sample of 44 bingo players was added to the population sample to strengthen the dependent variable for regression analyses. Multiple regression analyses were used to define key characteristics of bingo players among 10 social or contextual factors and 5 lifestyle variables. Results Being female, more elderly, living in rental accommodation, receiving federal income supplements and reporting more health problems were significant predictors of more money typically spent on bingo (18% variance explained), and these findings lend support to the “little old lady” stereotype. However, sedentary living, rather than smoking, was the only significant and predictive lifestyle pattern, suggesting that the lifestyle vices projected about bingo players are not entirely accurate. Conclusions Elderly women of marginal means do dominate the game of bingo in terms of money spent, but their gaming lifestyle apparently has less to do with habits of smoking, eating poorly, drinking alcohol, or having excessive leisure time, and more to do with sedentary recreation that is socially delimited by their gender, age, income and health.     

Restrictiveness of Eligibility Determination and Medicaid Enrollment by Low-Income Seniors

Medicaid is an important source of supplemental health care coverage for low-income seniors, yet little is known about the effect of state policy on Medicaid enrollment by eligible elderly. Data from a nationally representative survey were used to examine Medicaid enrollment by elderly, low-income Medicare beneficiaries living in states that liberalize or restrict Medicaid eligibility criteria using the 1986 Omnibus Budget Reconciliation Act or provision 209(b) of the 1972 Social Security Act Amendment, respectively. Controlling for demographics and health status, residence in states applying these laws was significantly, though modestly, associated with Medicaid enrollment. Additionally, 73% of eligible elderly Medicare beneficiaries were not enrolled in Medicaid, and most have serious chronic health problems. These findings suggest that a significant number of eligible elderly are not enrolled in Medicaid and that liberalizing or tightening Medicaid eligibility criteria can have an impact on Medicaid enrollment by low-income elderly patients.     

Family Characteristics and Mate Selection: Evidence From Computer‐Assisted Dating in Japan

Research on mate selection rarely considers singles' preferences for their future partners' family configurations and experiences. Using online dating records from a matchmaking agency in Japan, a society with a strong emphasis on family and kinship, we examine how singles' responses to date requests correspond to potential mates' family circumstances. Results showed that singles' preferences for potential partners' family characteristics stem from a concern about future obligations toward the partner's family and stereotypes associated with certain family traits. Singles are less likely to accept requests from those from large families, which are seen as traditional. Being from a large family, however, hampers individuals' dating chances more if they are firstborn and have no brothers, two conditions that make them the designated child to care for elderly parents. We also find that Japanese singles seek partners with more of the universally valued family traits rather than traits similar to their own.     

Canada and Family Life

Abstract

Important Canadian factors are discussed to obtain a profile of this country, its communities, and family trends. The challenges for Canadian families are presented and include the sandwich generation, seniors, effects of divorce and remarriage, and same-sex marriages. A review of existing studies related to the strengths of Canadian families is included. The need for families to be strengthened has led to a variety of social supports available to the families of Canada.     

Injustice in family care of the Chinese elderly in Hong Kong

With increasing longevity, family care of the Chinese elderly in Hong Kong is evolving as a "caring trap" for female caregivers, especially unmarried daughters. Despite this, as Hong Kong is still a patriarchal Chinese society, most of the major decisions affecting the destiny of frail elders are made by sons or other male members of the family. The unequal gender roles, obligations, and division of caregiving responsibilities within the Chinese family and their effects on the caring relationship are discussed. Implications of this injustice based on gender regarding family care of the elderly and the possibility of its elimination are examined.     

Injustice in Family Care of the Chinese Elderly in Hong Kong

With increasing longevity, family care of the Chinese elderly in Hong Kong is evolving as a "caring trap" for female caregivers, especially unmarried daughters. Despite this, as Hong Kong is still a patriarchal Chinese society, most of the major decisions affecting the destiny of frail elders are made by sons or other male members of the family. The unequal gender roles, obligations, and division of caregiving responsibilities within the Chinese family and their effects on the caring relationship are discussed. Implications of this injustice based on gender regarding family care of the elderly and the possibility of its elimination are examined.     

Effects of Caregiving on Employment and Economic Costs of Chinese Family Caregivers in Canada

A telephone survey with 339 randomly selected Chinese Canadian caregivers examined the employment and economic costs of family caregiving for the elderly. Although the Chinese culture places a strong emphasis on filial obligation, caregiving is not without economic consequences. Caregiver’s age, financial adequacy, and employment, caring for an additional care receiver, and levels of assistance in Activities of Daily Living (ADL), were the predictors for economic costs perceived by family caregivers. Caregiver’s age, caring for an additional care receiver, and care receiver’s financial adequacy were significant predictors for male caregivers. Caregiver’s financial adequacy and higher levels of assistance in ADL were the predictors for female caregivers. Policies to support family caregivers should not just focus on the social aspect, but also the financial needs.     

Identity cues and dementia in nursing home intervention

This study examines the identity cues that family caregivers and healthcare personnel use with seniors living with dementia and living in nursing homes. The identity cues represent biographical knowledge used to stimulate the dementia sufferer, trigger signals and incite interaction. Our grounded approach hinges on three objectives: to identify and categorize identity cues; to document their uses; and to gain a better understanding of their effectiveness. We interviewed nine family caregivers and 12 healthcare workers. Qualitative data indicates that the participants use identity cues that evoke seniors' sociological, relational and individual characteristics. These identity cues play a central role in communication and constitute important information that the family caregivers can share with healthcare personnel. They sustain memory, facilitate care and reinforce seniors' self-value. These results help to define identity, foster a greater role for family caregivers, and constitute a sound basis for the implementation of personalized interventions.     

Living arrangements of elderly women and men in Chinese cities

Based on data from the 1988 Nine‐City Survey of the Elderly Aged 60 and Over, this study uses multivariate technique to examine how and to what extent demographic and socioeconomic characteristics of the elderly may motivate or discourage coresidence with married children. Focusing on seniors who have at least one married child, it contrasts two outcomes: living with married children and not living with married children. The analysis shows that being married and healthy significantly reduces coresidence with married children, whereas being financially dependent significantly increases the probability of coresidence. In addition, in contrast to the situations found in other Asian societies, gender is shown to have significant effect on coresidence, even after other variables are controlled.     

The lobby as an arena in the confrontation between acceptance and denial of old age

In two anthropological studies on old-age institutions, the lobby is found to be an arena in which one may examine the styles that seniors use to cope with the end of life. The lobby seemingly symbolizes the socioexistential situation of today's elderly and gives us a credible view of two separate types of institutions: sheltered housing and the old-age home. The article examines three levels of context: the static “set” in the lobby, the traffic of tenants and others through it, and the extent of freedom in its access. The article concludes that each institutional context “promotes” a different style of coping. Sheltered-housing tenants cultivate a middle-aged identity in which they deny the fact that they are old; tenants of the old-age home accept the manifestations of old-age and conduct an overt discourse with death. The reality of life in an institution as one that forces people to cope with question of identity in old age creates an appropriate background for discussion of the costs and utilities of each style of coping.