Geriatric hospitals in India, today and in the future

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.     

Family Work Performance and Satisfaction

Abstract

Using data taken from a random sample of married and cohabiting couples (N =96), we examine the factors associated with a couple's division of unpaid family work. We extend the usual analyses by testing, in addition to gender ideology and relative resource factors, the role of a partner's emotion-work performance. We find that all three perspectives are relevant to the discussion of unpaid family work: gender ideology and relative resources are associated with the division of housework and child care, and partner's emotion-work performance is the most predictive of domestic-labor satisfaction. doi:10.1300/J002v40n04_04     

Community Care in Taiwan

SUMMARY

This article explores the policy definitions and the funder roles of central and local governments in community care in Taiwan. The notion of community care has been adopted in Taiwan following the model of Hong Kong but the main question of the article is whether this has resulted in actual service provisions at the community level, forming an alternative to institutional care. The data has been collected from several sources: policy documents, official statistics, surveys, general reports, funding provision reports, and empirical studies. The results show that neither central nor local authorities are seriously involved in caring for elderly people or persons with disabilities in Taiwan's communities. In Taiwan, community care for these groups of people still means, in practice, informal care provided by female family members without any support from public policies.     

Commentary

Abstract

The Family and Medical Leave Act provides unpaid leave but a key component is its intergenerational structure, permitting employees to take time off from work to care for an infant as well as an ill elderly parent. However, in an effort to provide paid leave, 23 of 28 states dropped the elder care provision in new initiatives introduced between 2000 and 2003. This article argues that in reforming leave policy in the future, the leave should be paid, remain intergenerational, cover more workers, and be adaptable to changing family patterns in an aging society. Also discussed is California's paid leave law, which meets these criteria.     

Kin Keeper

Abstract

Cancer mortality issues for African-American women are undeniably real. It is also apparent that to address the issue of this unequal burden, different intervention approaches are necessary. Employing a family systems approach for African-American women and their families holds benefits for both cancer prevention and cancer treatment. The Kin Keeper Modelis based on the premise that the natural ways African-American women communicate various health messages to females in their family can be used to influence their cancer prevention and screening behaviors. This paper reports empirical research that demonstrates significant familial influence on African-American women's cancer prevention screening behaviors. Findings indicated that family influence provides insight into the intersection of family altruism with cultural familial decision-making. In addition, the findings underscore the strong influence family has on African-American women's propensity to     

Deficits in young men's knowledge about accessing sexual and reproductive health services

Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). Results: Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. Conclusions: Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.     

Women's Status and Social Capital in the United States

SUMMARY

Robert Putnam's Bowling Alone found that social capital is closely associated with a variety of important indicators of community health, and women benefit from many of these resources as members of their communities. But is there anything distinct about how women experience social capital? Is there a relationship between social capital and women's status overall? Using data on social capital from Bowling Alone and data collected by the Institute for Women's Policy Research for its Status of Women in the States project, we assess trends across the states on both dimensions. Overall, the findings suggest that there is a strong relationship between the two.     

The Ethics of Medical Decision-Making with Japanese-American Elders in Hawaii

SUMMARY

This study reports observations by oncology nurses, doctors, social workers and administrators at Queen's Medical Center (QMC) in Honolulu (N = 50), concerning cultural, religious and institutional factors influencing mentally competent Japanese-American elders signing medical informed consent (IC) documents without understanding them. Sixty-eight percent of respondents reported having observed elderly Japanese-Americans signing IC documents without understanding them. Explanatory concepts of enryo(refraining from imposing one's own interest or desire), oyakoko(filial piety), ishin-denshin(silent communication) and obasute(a traditional practice of sacrificing oneself to avoid being a burden to others), in addition to other cultural concepts are discussed for their possible contribution to “signing without understanding.” Suggestions are made for further research to include elders and their family members to explore the perceptions of IC. The study concludes with recommendations for improvements to the laws, policies, programs and procedures governing the IC process in order to achieve a better fit with the cultural, ethnic and religious characteristics of Japanese-American elderly patients in America.     

Letters

Abstract

Approximately 500,000 children were institutionalised in Australian orphanages and other forms of children's Homes over the course of the 20th century. However, growing up in care is not just a part of childhood; it can have ongoing impact across a person's life. Access to records can be a very important way in which people who grew up in institutional care construct the story of their lives, contributing to their self-identity, and also find out practical information, such as their exact date of birth and medical history. The present article takes as its starting point a recommendation of the third of the Australian Government reports concerned with the institutionalisation of Australian children—Forgotten Australians—and draws on interviews with former residents of children's Homes aged between 42 and 76 years to examine their access to records in Australia. We discuss a case study, the unique Heritage Information Service at MacKillop Family Services, which supports former residents to access their records, and consider the implications for good practice of agencies working in this area.     

Health System Reform and the Elderly: The Case of Israel

Abstract

Following the implementation of the National Health Insurance Law in January 1995, major changes have taken place in the provision of health services by Israel's sick funds and the way these services are funded. This article presents the principal changes that have occurred and assesses their impact on those aged 65 and older, using findings of a survey conducted one year after the law's enactment. While the findings show that the elderly's situation has improved in some areas, they also raise concerns that the elderly are having difficulty navigating the reformed health system and that they are not benefiting from the new competition among the sick funds.     

Impact of an Intergenerational Program on 4th Graders' Attitudes Toward Elders andSchool Behaviors

Abstract

The rapid growth of the elderly population coupled with research demonstrating the existence of ageist stereotypes even among very young children have led to the rise of intergenerational programs. Very limited research has been conducted, however, to demonstrate the effectiveness of these programs in producing attitudinal change or other beneficial outcomes for at-risk children. This study examined the impact of an intergenerational program on children's attitudes toward elders and on their school-based behaviors. Eighty-one 4th grade children enrolled in an inner-city school participated in the study. Forty-one children, with matched seniors partners, engaged in activities based on the 4th grade core curriculum within an outdoor classroom environment, while the remaining 40 children participated in usual core curriculum activities. At the conclusion of the program those children who participated in the program had significantly more positive attitudes towards the elderly and significantly better school behavioral grades than did non-participating students. Impli-     

Neurobiological Causes of Addiction

Abstract

Neurobiology and molecular genetics are contributing heavily to a new understanding of the causes of chemical dependence (“addiction”). Willful chemical abuse is a problem that continues to produce significant societal costs including accidents, medical expenses, and family suffering. Pathological chemical dependence, on the other hand, is being recognized as a true medical disease that is also devastating, but in different ways. There is strong evidence in animals and humans that chemical dependence involves a dysregulation of the pleasure pathway (the “medial forebrain bundle”), located in the mesolimbic portion of the brain. Dopamine is one of the medial forebrain bundle's major neurotransmitters. In this paper, we provide a research-based model for the causes of chemical dependence and its treatment, and integrate this information with classic Twelve Step treatment programs.     

Age Concerns

Summary

Age Concerns is a proprietary care management firm serving the elderly. Established in 1982, the firm has prospered by employing an integrated model of care whereby the caregivers are employees of Age Concerns. In addition, the firm's ability to keep the elderly at home, out of institutional care, has resonated with consumers. Various features of Age Concernsorganizational format, characteristics of consumers, and economic considerationsare described. In 2001, Age Concerns was acquired by the Senior Care Action Network, a social health maintenance organization. In an increasingly commercial environment in which the elderly are a burgeoning market, Age Concerns may be a prototype of future elder-care service delivery.     

Long-Term Care Policy Reform in Japan

Summary

The implementation of Japan's Long-Term Care Insurance Scheme in April 2000 was the culmination of some 30 years of policy deliberation on aged care. Understanding the policy debate surrounding the Long-Term Care Insurance scheme and its financing arrangements requires an appreciation of rapid demographic and social change, especially in family structures and attitudes to caring for aged parents; but the pressures that population aging and economic downturn are placing on Japan's pension and health insurance systems also must be recognized. Even more generally, the delicate balance of political interests in Japan's central governing body, the Diet, has shaped the implementation of Long-Term Care Insurance as a forerunner to other reforms in social security and health insurance.     

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.     

The Wisdom of Non-Heterosexually Based Senior Housing and Related Services

Abstract

Understanding the housing needs of non-heterosexual seniors will improve the delivery of social services to more than 3 million gay, lesbian, bisexual and transgender seniors in the United States and aid in the development of new service-enriched housing models for the benefit of all service dependent populations. The feasibility and demand for non-heterosexually based senior housing and related services, however, has received negligible attention. This study is a first step and San Francisco is an ideal place to begin because of the community of non-heterosexual seniors, the City's housing market, the social service resources available to seniors, in general, and the social service delivery technology evolving in response to the AIDS crisis.     

Family and Friends as Respite Providers

Abstract

Consumer-directed service options in home- and community-based care are increasingly available to adults with chronic conditions and cognitive impairments and to their family caregivers. Few studies, however, examine the experience of family caregivers who, when given a choice of providers of respite assistance (i.e., relief from the stress of providing constant care), prefer to hire family or friends rather than service providers. This study describes the in-home respite experience of family caregivers served by California's Caregiver Resource Centers “direct-pay” program who hire family or friends (n = 39) or service providers (n = 77) to provide in-home respite assistance. Findings revealed similarities between the two groups with few exceptions: caregivers who hired family or friends reported poorer physical health, were slightly more satisfied with the respite assistance, and received more hours of respite at a lower unit cost. These findings lend support to consumer-directed respite service options where family caregivers are given flexible alternatives that may act to remove barriers to respite service availability and use.     

Impact of an Intergenerational Program on 4th Graders' Attitudes Toward Elders and School Behaviors

Abstract

The rapid growth of the elderly population coupled with research demonstrating the existence of ageist stereotypes even among very young children have led to the rise of intergenerational programs. Very limited research has been conducted, however, to demonstrate the effectiveness of these programs in producing attitudinal change or other beneficial outcomes for at-risk children. This study examined the impact of an intergenerational program on children's attitudes toward elders and on their school-based behaviors. Eighty-one 4th grade children enrolled in an inner-city school participated in the study. Forty-one children, with matched seniors partners, engaged in activities based on the 4th grade core curriculum within an outdoor classroom environment while the remaining 40 children participated in usual core curriculum activities. At the conclusion of the program those children who participated in the program had significantly more positive attitudes towards the elderly and significantly better school behavioral grades than did non-participating students. Implications and recommendations for intergenerational programming are discussed.     

Oregon's Efforts to Reduce Elder Financial Exploitation

ABSTRACT

Several programs have been undertaken in Oregon to reduce financial abuse. They include the production of a multi-media training kit by the Oregon's Attorney General's Task Force with funding from the US Department of Justice, creation of an “Elder Financial Exploitation Prevention Program” that educates seniors “at the scene of the crime,” and distribution of devices to assist elders in ending unwamted phone calls and direct mail solicitations.