Understanding the Pattern of Support for the Elderly:

Cross-cultural comparison can offer critical input to analyses of the interplay between formal and informal services for the elderly. Israel and Sweden have very different population structures and represent different points on the spectrum of welfare state development: Sweden has a much higher percentage of elderly, a less traditional family structure, and a much more developed system of public support. In addition, there are thought to be different attitudes toward family ties, with a less family-oriented value structure in Sweden. The natural question is to what extent these differences translate into differences in the extent and nature of family support for the elderly. In this article, family structure, living arrangements, disability rates, and formal and informal sources of help in Sweden and Israel are compared at various points in time. While there is a greater rate of formal service provision in Sweden and some substitution for family support seems to have occurred, informal care has nevertheless remalned important. In both countries, residential palterns are critical: it is when the elderly live alone that the formal system has tended to replace the family. The rate of institutionalization is particularly important in determining the rate of disabled elderly requiring care, both formal and informal, in the community.     

A suggestion for future research on interface design of an Internet-based telemedicine system for the elderly

Telemedicine has emerged as an effective tool for providing high quality healthcare service and health-related information, especially in rural areas. Rural areas often have a larger elderly population with greater rates of preventable disease. These areas also have fewer medical resources and specialists, and have limited access to health services, all of which can influence overall health. An Internet-based telemedicine system can be one solution to provide the rural elderly with the proper health information when needed. The elderly obviously have limited capabilities compared with younger adults in the use of internet technology. However, the interfaces of the currently existing Internet-based telemedicine systems are not specifically developed for elderly users. This paper suggests future interface design research for an Internet-based telemedicine system specifically for the elderly.     

Understanding the pattern of support for the elderly: a comparison between Israel and Sweden

Cross-cultural comparison can offer critical input to analyses of the interplay between formal and informal services for the elderly. Israel and Sweden have very different population structures and represent different points on the spectrum of welfare state development: Sweden has a much higher percentage of elderly, a less traditional family structure, and a much more developed system of public support. In addition, there are thought to be different attitudes toward family ties, with a less family-oriented value structure in Sweden. The natural question is to what extent these differences translate into differences in the extent and nature of family support for the elderly. In this article, family structure, living arrangements, disability rates, and formal and informal sources of help in Sweden and Israel are compared at various points in time. While there is a greater rate of formal service provision in Sweden and some substitution for family support seems to have occurred, informal care has nevertheless remained important. In both countries, residential patterns are critical: it is when the elderly live alone that the formal system has tended to replace the family. The rate of institutionalization is particularly important in determining the rate of disabled elderly requiring care, both formal and informal, in the community.     

High-Tech Amenities for the Elderly: The Technological Assistance Needs of Elderly Koreans Aging at Home

This study builds on existing literature regarding residential technological systems and the elderly. This study investigates elderly Koreans’ needs for technological systems in their residential environments and makes appropriate suggestions for creating high-tech amenities to support their aging at home. This study surveyed 60 elderly Koreans and presented them with 5 categories of 24 technological systems to evaluate. Results of this study show that participants were willing to adapt technological systems in their residential environment without any technophobia. In terms of their needs, the participants ranked the safety and security system category first, the indoor environment control system category second, and the health-related system category third. The results of this study suggest that residential environments, including individual housing and apartment properties, should incorporate technological systems to extend elderly residents’ independent living at home.     

Defining the challenges of providing long-term care: the case of the nursing home industry's response to the AIDS epidemic

Acquired Immune Deficiency Syndrome (AIDS) is now viewed as a chronic disease requiring long-term management. As a result, more persons with AIDS (PWAs) are seeking long-term care in facilities that have primarily served the elderly. In some regions, however, the nursing home market into which PWAs may introduce new demand is a market already characterized by excess demand. In light of this, competition for limited long-term care resources may develop between the frail elderly and PWAs. The nursing home industry has raised many issues regarding the feasibility of admitting AIDS patients as residents, but little is known about how important these issues are in deciding admissions policy. How the industry perceives and resolves the concerns it has regarding delivery of care to PWAs can affect the overall long-term care system and thus affect the traditional users-the frail elderly. Knowing the concerns and preferences of the industry may help guide and anticipate future changes in the system. In this pilot study, a random sample of 250 nursing home administrators in the five highest AIDS-incidence areas in the United States was surveyed to determine (1) the industry's concerns and issues regarding AIDS care, (2) data regarding requests for admission by PWAs to nursing homes, and (3) data concerning the industry's preferred way of delivering AIDS care. Important admissions policy issues cited by the respondents included the ability to meet special care needs, costs of care, and inadequate reimbursement. The majority also believed the most appropriate methods of providing care were special care units for AIDS within nursing homes or dedicated HIV/AIDS nursing facilities.     

失能老年人长期护理的需求规模评估、费用测算与经济效应预测

伴随着失能风险的增加,老年人长期护理问题成为人口老龄化研究的新课题.基于CHARLS等相关数据,改进Markov模型,测算2020—2060年失能老年人长期护理需求规模及费用,并预测经济效应,结果表明:(1)老年人数量呈倒"U"形增长趋势,并于2048年左右达到顶峰,约为4.34亿人;失能老年人呈逐年上升趋势,于2060年达到1.84亿人.(2)失能老年人长期护理费用由2020年的3906.57亿元增长到2060年的44973.16亿元,增长11.51倍,其中轻度、中度和重度失能老年人长期护理费用分别增长8.92倍、15.55倍和21.17倍.(3)老年护理劳动力需求量预测显示,由90.33万人上升到228.98万人,增长2.54倍;机构养老护理型床位需求量预测显示,由241.03万张增长到553.11万张,增长2.29倍;老年护理市场直接经济增量预测显示,由3906.57亿元增长到44973.16亿元,增长11.51倍.基于此,本文提出包括坚持"以制度为基础、以服务为核心、以救助为兜底、以法律为准绳"的基本原则,建立失能动态监控机制,完善养老服务财政补贴制度等政策建议.     

Acessibility in collective housing for the elderly: a case study in Portugal

Physical spaces need to be adjusted to suit the changes of a physical, cognitive and emotional order occasioned by the natural aging of people. Ergonomics of the built environment contributes to improving the interaction of the user and physical environment, with a view to their comfort and safety. By thinking through the influence that environments have on the quality of life of the elderly, this article presents an assessment of accessibility in private units--bedrooms and bathrooms--of a Long-Stay Institution for the Elderly (ILPI in Portuguese) in Portugal. The analysis of the physical and spatial conditioning factors by means of the Ergonomics Methodology for the Built Environment (EMBE), proposed by VILLAROUCO (2008), gave evidence of the need for interventions to suitably adapt physical infrastructure, with the objective of promoting the physical well-being of the elderly, and thus, enhancing the autonomy and independence of a wider range of users.     

Long-term care policy for the elderly in the Zaporozhye region of Ukraine: a case study of social development following the collapse of Communism

In this paper, we review the status of social policy for the elderly in Ukraine since the fall of Communism and the breakup of the Soviet Union. We specifically address the problem of "rebuilding" an income and services policy for the at-risk elderly after the unraveling of the system that existed prior to the fall of Communism. Also, we address some existing problems faced by the elderly in the health care system. Within this context, we present a case study of the current status of long-term care policy for the elderly in one province of Ukraine, the eastern province of Zaporozhye, encompassing the industrial city of Zaporozhye on the Dnieper River. This case study particularly pays attention to current attempts to promote a social development process of long-term care services for the elderly. It examines recent developments with respect to public sector organizations and voluntary sector organizations that are trying to provide necessary services to the needy elderly. With respect to the voluntary sector, the paper pays particular attention to the American Jewish Joint Distribution Committee (JDC) model of a largely externally funded NGO that provides comprehensive and integrated social supports, while emphasizing local empowerment and the use of volunteers, for the needy Jewish population in the province of Zaporozhye. Based on our findings, we make some proposals regarding the improvement of income and services policy with respect to the elderly in Zaporozhye and Ukraine.     

The public library system. Social services resource for the geriatric population

The public library system is targeting the geriatric population and instituting programs to meet informational and recreational needs. From retirement planning, visual aids, and screening, to accessing library material to the elderly, the public library system attempts to meet the challenge of providing service to this special population. Although not a formal group, the library has inherent therapeutic effects that benefit the elderly who participate in their programs. The clinician would be advised to take advantage of these various programs. Because each local and regional center will offer different programs, calling a local library is the most effective way to find out what a specific public library system has to offer. Nurses may also consider joint efforts to initiate programs in their library systems to better meet the population's needs.     

The supportive community: a new concept for enhancing the quality of life of elderly living in the community

This study examines supportive community programs in Israel, which aim to improve the quality of life of the elderly. These innovative programs pool existing resources to provide a benefits package that includes medical services, an emergency call switchboard, a "neighborhood facilitator," and social activities. Data were collected in 2000-2001 using qualitative and quantitative methods. The program provides specific services to meet needs that otherwise are not adequately addressed. The major contributions of the program reported by the members was increasing their personal security (two-thirds), easing the burden on their children (one-third), and enabling them to remain at home (one-quarter). The supportive community program enriches the variety of services available, thus providing the elderly with the choice of staying within their familiar surroundings of their homes and neighborhoods. This model appears to be both a cost-effective way to facilitate aging in place and a way to meet many of the elderly's essential needs, thereby maintaining their quality of life.     

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.     

Interactive remembering: Insights into the communicative competence of older adults

This paper challenges some of the traditional views of older adults' speech by considering conversational narrative interaction among three elderly peers from a life-span developmental perspective of aging. A range of pragmatic models developed primarily for younger adults' talk are extended to facilitate an analysis of interaction among elderly peers, showing how the speakers in the data use sophisticated strategies to recall events and establish communicative bridges between conversation participants. The differing social and communicative goals of older adults are examined, contrasting their communicative, and particularly narrative, competency with negative perceptions of elderly discourse, thus demonstrating that to view aging as synonymous with linguistic decline is unfounded.     

Japan's financing system for health care of the elderly

The multiplicity of Japan's health insurance system fails to achieve equality among the different insurance groups of the sharing of the financial burden. This "horizontal" inequality is effectively offset by a unique redistribution mechanism established in 1982. However, there is no reserve fund so that savings can be accumulated for the greater financial need in the future. This will inevitably lead to a heavier financial burden for the future working generation or more utilization of the personal assets of the elderly. How to achieve "vertical" or intergenerational equality in financing the cost of health care for the elderly is the biggest social policy challenge for Japan.     

Japan's Financing Systems for Health Care of the Elderly

The multiplicity of Japan's health insurance system fails to achieve equality among the different insurance groups of the sharing of the financial burden. This "horizontal" inequality is effectively offset by a unique redistribution mechanism established in 1982. However, there is no reserve fund so that savings can be accumulated for the greater financial need in the future. This will inevitably lead to a heavier financial burden for the future working generation or more utilization of the personal assets of the elderly. How to achieve "vertical" or intergenerational equality in financing the cost of health care for the elderly is the biggest social policy challenge for Japan.     

An Assessment,Using the Multiphasic Environmental Assessment Procedure (MEAP), of a Rural Life-Care Residential Center for the Elderly

This study reports the findings of an assessment of a life-care center for elderly persons in a rural area using the Multiphasic Environmental Assessment Procedure (Moos and Lemke, 1979a). The study assesses the physical and architectural features, the social climate, and the policies and programs of the home. The results are compared to previous assessments of sheltered-care facilities, and the findings of the study support similar research conducted by Moos and Lemke. The facility's selection process leads to a population with similar characteristics, tending to promote a harmonious environment. The residents have a positive perception of their personal environment which encompasses the physical and social environment and organizational structure. This type of environment offers a smooth transition from living in a private residence to a residential life-care center.     

The politics of care for elderly people in Scandinavia

Most of the European countries struggle with a lack of public resources for the care of elderly people. Several comparative studies have shown that the ‘social democratic’ welfare regime of Scandinavia offers more public services to older people than any other regime. This is true both for institutional care and home care. The national averages, however, hide some serious problems. The responsibility for the care of elderly people has been transferred to the municipalities. This is threatening one of the cornerstones of the Scandinavian welfare state, equality. Access to care is increasingly becoming a question of which municipality you happen to grow old in. While inequality seems to be the problem when comparing elderly living in different municipalities, too egalitarian a policy seems to be a problem within the municipalities. In a situation where every old person is entitled to get help, the number of old people is growing and the economic resources are restricted, the cheapest form of care, ‘thinly spread’, often seems to be the only solution. It is argued that this leads to unnecessary institutionalisation. Whether there are other solutions, and what consequences they have, is also discussed. Empirical findings from a study of the care of older people in five municipalities in Denmark, Finland, Iceland, Norway and Sweden from 1991 to 1995, will be used as examples.     

养老服务的逻辑、实现方式与治理路径

养老服务是不同供给主体将不同内容、质量和价格的养老产品或项目,以不同的方式配送到不同需求老年群体的过程。不同供给主体基于责任驱动和利益驱动,为需求主体提供适应性养老服务,是养老服务的基本逻辑。养老服务的实现,是在特定地域、特定的社会关系网络中,通过优化配置养老服务资源,聚集整合养老服务资本,来保障有质量、有尊严的老年生活。鉴于养老服务供给的多元性和需求的复杂性,养老服务的治理则需要运用先进的合作治理与参与治理理念、选择科学的治理工具和现代化的治理技术,保障养老服务供给与需求的适应性匹配,进而保障养老服务实现方式的有序运行。     

An ICT-Driven Hybrid Automation System for Elderly Care Support: A Rehabilitation Facility Study Case

Abstract

The demographic statistics in developed countries suggest growth in the elderly segment of the population. At the same time, other studies forecast a shortage of nurses, increasing the pressure on hospitals to provide treatment for longer periods of time. These trends suggest a need for new ways of taking care of the elderly population that support safe, comfortable, and independent living. Meanwhile, prominent advances in information and communications technology (ICT) have enabled new systems that address various needs of the elderly. This article presents a case study of a rehabilitation facility located in Tampere, Finland, that uses an automation system in which ambient assisted living (AAL) and building automation (BA) system functionalities are combined. It details a field study summarizing the needs of the users, describes functional scenarios supported by the system, and reports the results of the first usability tests suggesting acceptance of a new technology by residents and caregivers. The unique combination of ambient assisted living and building automation offers a safer and more comfortable environment for the elderly as well as helps caregivers on-site in managing their workloads.     

THE ELDERLY VICTIM OF HOMICIDE:

This study attempts to resolve some of the disparity between lifestyle/routine activities theory and empirical findings concerning the elderly victim of homicide. Analysis of Canadian data leads to the conclusion that the elderly are disproportionately victims of theft-based homicide, a finding not consistent with the routine activity approach. A reformulation of the theory resolves the theory/data gap.