Private lives and public programs: an Australian longitudinal study of the elderly

Major late life events, reported in the Dubbo longitudinal study of older Australians, are used to examine the interaction of private lives with public programs. First, the data indicate strong supportive effects of publicly funded income, health, and aged care programs in reducing family burdens from major life changes. In particular, financial crises were rarely mentioned, directly or indirectly, as major threats. Next, the central role of informal social support in these events is demonstrated, first, as in previous studies, family support was responsive to risky events and to aging itself. Also, in new findings, one-third of surviving elderly respondents coped with the burdens of family crises as a substantial proportion of the "major" life changes that occurred over 13 years of the study. Within the security and support provided by the Australian welfare system, and with strong social networks, families with older persons in the Dubbo study manage multiple, major life changes. With rapid population aging, the development of more, and more easily accessible, services for a growing population of older people is a priority. The critical challenge will be to harmoniously grow public financing, private funding, and informal caregiving to deal with the growing burden arising from an aging society.     

The Perspectives of Older Greek-Australians Toward Changes in the Nature of Family Support: Implications for Family Care Policies

Internationally, public policies encourage “aging in place,” and the majority of older Australians requiring care in the community receive informal care, supplemented by publicly subsidized formal services. The effect of contemporary social changes on informal care in aging migrant communities is poorly understood. This articles explores the perceptions of older Greek-Australians toward changes in the nature of family support. Bicultural and bilingual researchers carried out in-depth interviews (n?=?27) and five focus groups (n?=?63 total participants) with older Greek-Australians in modern Greek. While “cultures of care” remain among Greek-Australian families, the means for a family to assist have shifted, and these compromises are met with considerable powerlessness among older Greek-Australians. Implications for policy include the need to better involve older migrants and their families in decisions about their care needs, potentially involving consumer-directed care models. Service providers may also need to adopt the use of new technologies to communicate with increasingly time-pressured family members.     

Assisted Living for Lower-Income and Frail Older Persons from the Housing and Built Environment Perspective

Abstract

This paper examines the linkages between housing and supportive services from the built environmental perspective. When it comes to linking supportive services, it is usually true that the wealthier an individual is the more private resources he or she has available to define a personal support system at every step in the aging process; the poorer the individual is, the fewer choices she or he has and the successful linkages of government subsidized housing, health and supportive services become more important to successful aging of that person. Low-income and aging individuals are the real testing ground for whether current policy allows holistic support linkages to occur and whether programs are available in both the quantity and quality to empower low-income older persons with options and support choices.

The discussion that follows is limited to supportive services and aging in place in conventional housing and affordable purpose built assisted living programs and facilities; it omits institutional living. For low-income older persons, institutional care provides few if any housing choices or individual power to control support delivery, and thus linkages between cooperating support professionals and programs becomes increasingly moot.     

Intergenerational Programs and Practices in China: Results Based on a Web Search Method

ABSTRACT

In the midst of an aging population trend and increased concerns about elder care, the Chinese government has developed policies that aim to strengthen family support systems and ensure older adult engagement in community life. One domain of related intervention that has received relatively little attention and systematic study in China is in the area of intergenerational programming. To gain a sense of the breadth and types of intergenerational programs emerging in China, the authors employed a web search method utilizing Google and Baidu search engines. Findings indicate a fair amount of program innovation and diversity as well as a need for additional programmatic and policy measures to strengthen and support intergenerational relationships in family and community contexts.     

Natural neighborhood networks — Important social networks in the lives of older adults aging in place

Neighborhoods are important places of aging and meaningful contexts of life for many older people. The overall aim of this study was to explore the public life of older people aging in place in order to understand neighborhoods as the material places where public life occurs, networks as the social places of public life, and to examine how these neighborhoods and networks influence the experience of aging and wellbeing. Adopting a friendly visiting methodology, data was collected over an 8-month period using participant observation, visual methods and an innovative interview technique called the “go along method”. Data were analyzed using grounded theory and a coding strategy that integrated textual, visual, and auditory data. Results provide insights into the micro-territorial functioning of neighborhoods and highlight third places and transitory zones as significant sites for older residents. Embedded within these places is a natural neighborhood network — a web of informal relationships and interactions that enhance well being and shape the everyday social world of older adults aging in place.     

Mind the Gap: Built Infrastructures,Sustainable Caring Relations,and Resilient Communities in Extreme Weather Events

Abstract

Climate change debates seldom link the insights derived from the physical sciences to the concerns of social scientists. Understanding how failures in built infrastructures increase the caring burden on women is one of these instances. This article draws on a pilot study on climate change and older people to demonstrate that women who provide informal care services are called upon to fill the gap between declining levels of formal care provisions and care needs when the infrastructures serving a community fail. This research challenges policymakers, emergency planners, and practitioners to think about the increased care burdens that women are expected to undertake during disasters involving extreme weather events like heat waves, cold snaps, and flooding, and reconsider policies that pass this responsibility down to the level of community without the necessary support services and built infrastructures being in place. This issue acquires additional urgency in the context of declining levels of care being publicly funded through the age of austerity as public expenditure cuts begin to bite.     

Living Arrangements and Informal Support for the Elderly

ABSTRACT

A network of informal care and support provided by family, friends and neighbors often forms the basis for elderly care. Changes in the structure of Chinese family alter this supportive function, and changes in traditional values affect the nature of the network and support provided. This is especially so in modernized Hong Kong where the traditional role of the family and especially children's duty of care for their aged parents (“filial piety”) may be weakening. This proposition was investigated by a qualitative study involving in-depth interviews with 50 older persons in a modern new town (Tuen Mun) in Hong Kong. Living arrangements, geographical proximity and the quality of relationships between potential caregivers and the elderly affected needs for and provision of informal support. Traditional Confucian filial piety is undergoing modification, perhaps erosion, implying ongoing changes in inter-generational relations in this modernized Asian society.     

“My nest is full:” Intergenerational relationships at midlife

Incorporating a life course perspective, this qualitative study used focus groups to explore the experiences of midlife adults who were simultaneously providing support to emerging adult children and aging parents. Results indicated that adults situated in middle generations held beliefs that endorsed family-based responsibility to both younger and older members. Parents gladly supported children despite their longer transition to adulthood. Often unanticipated but accepted, provisions of care to aging parents were experienced with ambivalence — a joy and a burden. The transition of their parents to greater dependence helped participants gain insights into the terrain of late life and encouraged reflections about the intersection of aging, independence, and family responsibility. Participants expressed intentions to preserve their own independence and spare their children of caregiving burdens through self-directed actions. Implications focused on negotiations of family relationships around issues of independence and family responsibilities as a way to reduce intergenerational ambivalence.     

Demographic Comparisons of Aging in Five Selected Countries

The worldwide aging of the population is having a major impact upon society. The United Nations General Assembly has declared 1999 to be the International Year of Older Persons to increase the awareness of aging worldwide. They identified five principles for older persons: independence, participation, care, self-fulfillment, and dignity. The numbers of elderly are growing around the world with many elderly living considerably longer than in past times. Developed countries are struggling with the high cost of maintaining support programs, and developing countries face dissolution of traditional care systems without institutional replacements. Women around the globe typically live longer than men, often without the economic resources to maintain independence. As nations adapt to their aging populations, a partnership among policy makers, family members, and older persons themselves is needed to offer alternatives to meet the needs of elders.     

Gay Bars and Serendipity

Abstract

HIV/AIDS continues to be a serious public health issue. As HIV changes from an acute disease to a more chronic illness, it places increased responsibility on family caregivers to provide on-going assistance. Based on a conceptual model of caregiving resilience, this study found high variation in caregiving outcomes with many caregivers demonstrating high levels of well-being despite adverse life circumstances. Factors that contributed significantly to caregiver well-being included income, caregiver health, discrimination, multiple loss, dispositional optimism and self-empowerment. These findings suggest that HIV/AIDS and caregiving entail more than stress and distress and that future research needs to consider caregiving within the context of a historically disadvantaged community, resilience of informal caregivers, and risk and protective factors at the personal, cultural and community levels. Such information is necessary to design community-based interventions to support informal caregivers and persons living with HIV/AIDS.     

Friendship support patterns of older American women

Research during the past decade has firmly established the informal support of family, friends, and neighbors as critical in older people's health and well-being. The decade has also seen increasing attention to informal supports in social policy and services addressing the needs of older people. The support of friends in particular is agreed to be important but the details of its nature and consequence require more research. This article draws on field research of friendship among a population of older American women to ask: (1) How do older women themselves perceive their friendship involvement and its significance as a source of support?; (2) How do the friendship support patterns of later life compare and connect with those of earlier stages?; (3) How do friends relate to other sources of informal support in terms of support exchanged?; and (4) What are the implications for human service professionals concerned with effective use of informal support in later life?     

The Generational Equity Debate

This article discusses the generational equity debate in the United States-including its origins and the functions it serves. This debate has emerged in the context of concerns over the aging of the population, budgetary crises, growing health care costs, increased poverty among children, growing economic inequality, and declining faith in institutions. By potentially fragmenting support for Social Security and other social programs, the generational equity approach to framing public policy issues may serve the interests of those conservatives wishing to shrink and restructure the American approach to social welfare. However, the possibility exists that this debate could serve also as a forum to advance progressive ideas about universal access for persons of all ages to income and health benefits and employment opportunities.     

The generational equity debate: a progressive framing of a conservative issue

This article discusses the generational equity debate in the United States--including its origins and the functions it serves. This debate has emerged in the context of concerns over the aging of the population, budgetary crises, growing health care costs, increased poverty among children, growing economic inequality, and declining faith in institutions. By potentially fragmenting support for Social Security and other social programs, the generational equity approach to framing public policy issues may serve the interests of those conservatives wishing to shrink and restructure the American approach to social welfare. However, the possibility exists that this debate could serve also as a forum to advance progressive ideas about universal access for persons of all ages to income and health benefits and employment opportunities.     

Integrating Services for Older People in Aging Communities in The Netherlands: A Comparison of Urban and Rural Approaches

ABSTRACT

The aim of this article is to discuss approaches to services integration for older people in urban and rural aging environments in The Netherlands, and the preliminary effects of these approaches on local aging conditions. In urban areas, services integration revolves around the creation of functional spatial hierarchy. In rural areas, the emphasis is on forging links between service providers. Outcomes for health and use of professional care services are similar. Out-comes for housing, informal care, and accessibility of services differ between urban and rural areas in ways that can be traced back to local aging conditions and elements of the specific approach to services integration used. In both urban and rural areas, much more could be done to connect formal programs to the lifeworlds of older dwellers.     

Family Support for the Elderly in Korea

Abstract

This article discusses major issues and concerns regarding family support for parents and elderly people in industrialized and urbanized Korea. It summarizes new trends in family support for elderly members, continuing influences of the traditional value of family support (filial piety), growing needs for public services for elderly people and their families, urgent calls for the state to assume greater responsibilities for providing social security and services for the elderly, needs for cross-cultural studies of family support, and certain cultural similarities and differences to be considered. The article concludes with some suggestions for future research.     

Persistence and challenges to filial piety and informal support of older persons in a modern Chinese society: A case study in Tuen Mun,Hong Kong

Social support networks, consisting principally of family members, neighbors, and friends, can provide various support functions to older persons. As societies modernize, changes in family structure might alter this supportive ability, and changes in traditional values affect the nature of the network and support provided. This may especially be so in rapidly modernizing societies as in the Asia–Pacific region where the traditional role of the family and especially children's duty of care for parents (“filial piety”) may be weakening. This proposition was investigated by a qualitative study in a modern new town (Tuen Mun) in Hong Kong. In-depth interviews with 50 older persons in public housing estates were triangulated with data from focus groups and key informants. Living arrangements, geographical proximity, and the quality of relationships between potential caregivers and receivers affected needs for and provision of support, and there were interactions between various components of informal support. An important finding, which also has policy implications, is that traditional Confucian filial piety may be undergoing modification, perhaps erosion, implying ongoing changes in intergenerational relations in this modernizing Asian society.     

Informal caregiving for elders in Sweden: an analysis of current policy developments

In Sweden, care of elderly people is a public responsibility. There are comprehensive public policies and programs providing health care, social services, pensions, and other forms of social insurance. Even so, families are still the major providers of care for older people. In the 1990s, the family was "rediscovered" regarding eldercare in Sweden. New policies and legislative changes were promoted to support family caregivers. The development of services and support for caregivers at the municipal level has been stimulated through the use of national grants. As a result, family caregivers have received more recognition and are now more visible. However, the "Swedish model" of publicly financed services and universal care has difficulty addressing caregivers. Reductions in institutional care and cutbacks in public services have had negative repercussions for caregivers and may explain why research shows that family caregiving is expanding. At the same time, a growing "caregivers movement" is lobbying local and national governments to provide more easily accessible, flexible, and tailored support. In 2009, the Swedish Parliament passed a new law that states: "Municipalities are obliged to offer support to persons caring for people with chronic illnesses, elderly people, or people with functional disabilities." The question is whether the new legislation represents a paradigm shift from a welfare system focused on the individual to a more family-oriented system. If so, what are the driving forces, motives, and consequences of this development for the different stakeholders? This will be the starting point for a policy analysis of current developments in family caregiving of elderly people in Sweden.     

Hong Kong Chinese aging adults voice financial care expectations in changing family and sociocultural contexts: implications for policy and services

Despite being one of the world’s wealthiest cities, approximately one-third of Hong Kong older adults live below the poverty line. Innovatively using the Photovoice research method, this study invited 36 Hong Kong Chinese aging adults to photograph images and voice their concerns and expectations regarding financial care. Insufficient government support, diminishing family support, insecurity and fear regarding future finances, and strong desire for self-sufficiency through early preparation and bridge employment were recurring themes observed in the participants’ photographs and narratives. The shifting of the participants’ financial care expectations from informal to formal sources in changing family and sociocultural contexts indicated that older people are in urgent need of policy reform from a needs-based to rights-based approach to foster empowerment and fulfill older people’s rights of financial security, dignity and participation. Improving the retirement protection system should go hand in hand with encouraging family support and caregiving and creating age-friendly working environment for older residents. The findings of this study may have crucial policy implications for Hong Kong and other aging societies, especially those that share similar filial piety values and have seemingly ungenerous welfare systems.     

A Qualitative Exploration of Self-Regulation Behaviors Among Older Drivers

While much of the research on aging and driving has focused on sensory and motor changes, little is known about older drivers and the actual self-regulation adjustments they employ to continue driving safely. This research looks at how older drivers have made changes to driving patterns and behaviors that have allowed them to continue to drive without compromising their perceived safety, independence, and quality of life. Nine focus groups were held with older men and women aged 58 to 89 years. Some of the major themes that emerged were the following: older adults are very aware of age-related changes to driving; they perceive that self-regulation behaviors change with age; and they view transportation alternatives as limited or nonexistent. Policy implications include developing functional transit programs for older adults and car manufacturer training workshops to educate older adults on the safety features of newly purchased automobiles.     

Living Longer and Paying the Price?

Over the past century, there have been tremendous increases in longevity in the United States and most other developed countries. If these trends continue, the costs of paying for public programs like Social Security, Medicare, and Medicaid will escalate at a startling rate with the aging of the "baby boomer" generation. A meeting titled "Living Longer and Paying the Price?" was organized to consider whether current trends in longevity will continue at the current pace, accelerate, or decelerate as a result of public health problems such as obesity and infectious diseases. Further, speakers presented their views on covering the costs of public and private programs for future generations of older adults.