A Client Satisfaction Measure of Homecare Services for Older Adults

Client satisfaction can be used as an indicator for service quality. Without concrete feedback from clients, however, the usefulness of client satisfaction data for service improvement can be limited. This study described the development of a client satisfaction measure that can be used to provide concrete feedback for service providers. Based on a conceptual framework proposed in the literature, the Client Satisfaction: Home Care (CSAT-HC) uses a client-centered perspective to measure client satisfaction for homecare services for older adults. A survey of 200 older adults receiving homecare services provided by a social service agency in a large U.S. Midwest city was conducted to assess the psychometric properties of CSAT-HC. Results based on the 156 completed surveys show that CSAT-HC has good validity (correlation r = .62 with a popular client satisfaction measure) and test-retest reliability (r = .75). These results indicate that CSAT-HC is a valid and reliable client satisfaction measure; and therefore, providers of homecare services for older adults can use CSAT-HC to obtain client feedback for quality assurance or program evaluation purpose. Future research may use CSAT-HC to explore the potential influences of quality of homecare services on the well-being of older adult clients.     

Correlates of Depressive Symptoms among Homebound and Semi-Homebound Older Adults

ABSTRACT

This study aimed to provide a national profile of homebound and semi-homebound older adults with depressive symptoms and to compare risk factors of depressive symptoms by homebound status. A sample of 1,885 homebound and semi-homebound older adults was selected from Round 1 of the National Health and Aging Trends Study (NHATS). The prevalence of depressive symptoms was 43.9% in homebound older adults and 28.1% in semi-homebound older adults, representing over 830,000 and 1.4 million individuals in the population, respectively. Nearly two-thirds of homebound and over half of semi-homebound older adults with clinically significant depressive symptoms also had significant anxiety symptoms. Results from logistic regression showed that younger age, certain medical morbidities, severity of functional limitations, and pain were common risk factors for depressive symptoms among homebound and semi-homebound older adults. Some differences in the risk factor profile emerged between the homebound and the semi-homebound populations. Alleviating the burden of depression in the semi-homebound population may focus on early prevention that considers the diversity of this population. Home-based, integrated programs of health and mental health services that simultaneously address the medical, psychiatric, and neurologic comorbidities and disabilities of homebound older adults are needed to meet the complex needs of this population.     

High Life Satisfaction: Exploring the Role of Health,Social Integration and Perceived Safety among Mexican Midlife and Older Adults

We sought to investigate the relationship of high life satisfaction with important physical health, mental health, social integration and perceived safety factors among midlife and older Mexican adults. We examined 2,200 midlife and older adults (aged 50–101 years) from the Mexican arm of the Study on global AGEing and adult health (SAGE) and used binary logistic regression models to identify key factors associated with high LSA. Our final logistic regression model revealed self-rated health, affect, interpersonal activities and perceived safety on street to be significantly associated with high life satisfaction. Results from this study add to the nascent literature on subjective well-being of midlife and older Mexicans. Although social work with older adults is not well established in Mexico, researchers and practitioners should collaborate on the development and implementation of social worker-led strategies for prevention and intervention to enhance well-being among midlife and older Mexicans.     

Integrating Mental Health Parity for Homebound Older Adults Under the Medicare Home Health Care Benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.     

Home Modifications among Community-Dwelling Older Adults: A Closer Look at Race and Ethnicity

ABSTRACT

This study investigated racial and ethnic differences in home modification use. Data from the 2011 National Health and Aging Trends Study were used (n=6,764). Compared with non-Hispanic Whites, Hispanics were less likely to have a grab bar (odds ratio (OR) = 0.6), bath seat (OR = 0.8), or raised toilet (OR = 0.6). Non-Hispanic Blacks were less likely to have a grab bar (OR = 0.7) or bath seat (OR = 0.7) than non-Hispanic Whites, but more likely to have a raised toilet (OR = 1.3). English proficiency largely explained ethnic differences, while health status partially accounted for racial disparities.     

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.     

Key Determinants to using Telehealth Technology to Serve Medically Ill and Depressed Homebound Older Adults

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating chronic diseases, and comorbid depression among older adults, they have been slowly adopted by home health care (HHC) agencies. Therefore, this study aimed to identify factors that determine telehealth technology adoption. Twenty directors from the National Association for Homecare & Hospice member agencies completed a 45-min telephone interview. Questions were asked regarding their perceptions of telehealth, the key determinants of telehealth adoption and use, and recommendations they would give on telehealth adoption. The majority of the participants perceived telehealth as effective for managing symptoms and reducing cost. Meanwhile, some participants had a mixed feeling toward telehealth for depression care as they did not recognize their agency as equipped with the necessary resources and trained staff. Moreover, significant determinants of telehealth adoption included the agency-related characteristics, the patient-home environment, reimbursement and cost-related factors, and staff telehealth perception. Findings imply that there is a need for financial support both at the state and the federal levels to encourage telehealth adoption among HHC agencies. Future studies should consider exploring strategies used by successful programs to overcome barriers.     

Longitudinal Effects of Economic Preparation and Social Activities on Life and Family Relationship Satisfaction among Retirees

This longitudinal study examined the long‐term effects of economic preparation and social activity on life and family relationship satisfaction among retirees, particularly baby boomers. Data was obtained from the 2009 and 2011 Korean Retirement & Income Panel Study. A fixed effects model was employed to estimate unobservable individual‐specific effects and to control for study participants’ individual characteristics. The results show that both economic preparation and social activities have long‐term effects on baby boomers’ life and family relationship satisfaction. This study reveals that multidimensional aspects of preparation increase the long‐term impact of life satisfaction for retirees.     

Social Ties and Life Satisfaction of Older Persons:

Social ties, including family relationships, friendship ties, and community involvement are expected to inhance the life satisfaction of older people. But relationships among the social ties and the relative importance of these ties to life satisfaction remain unclear. To examine these relalionships, we analyzed data from more than 2,300 small-town Iowa respondents who were 50 years of age or older. Our results tended to support those reported in a previous article in this journal, particularly on the success of friendship ties and the failure of family relationships to predict life satisfaction. We found an even stronger relationship between community involvement and dissatisfaction with life, however. In addition, we analyzed data from four communities separately and found relationships varying substantially among them, thus influencing our conclusions.     

城市青年生活满意度与幸福感调查分析

根据对天津市青年的调查分析,当前青年群体对个人生活总体上比较满意,幸福感也处于较高水平。其中不同年龄、职业和收入者生活满意度差异显著,不同婚姻状况者生活幸福感差异显著。在生活满意度各项具体指标中,家庭生活、收入水平和人际关系对幸福感影响最为显著。     

Social Support,Caregiver Burden,and Life Satisfaction in a Sample of Rural African American and White Caregivers of Older Persons With Dementia

This article reports the findings of a study of African American and White dementia caregivers (n = 141) living in rural areas of Alabama that examined the relations between the participants' receipt of informal social support, and their levels of caregiver burden and life satisfaction. The sample, as a whole, reported high levels of social support with no reported differences in social support by race. Female caregivers reported higher mean scores on 3 of the 4 dimensions of social support than their male counterparts. Two of the 4 dimensions of social support accounted for 32% of the variance of the caregivers' reported level of life satisfaction.     

Organizational Changes and Job Satisfaction among Support Staff

ABSTRACT

The purpose of this study is to identify job satisfaction amongst support staff employed by a nonprofit company undergoing organizational changes. The Job Satisfaction Survey (JSS) scale was used to measure overall job satisfaction and was conducted among 38 workers and the data was analyzed using content analysis. The findings indicate that workers were satisfied with some sections of their job but also dissatisfied with some others, scoring an average job satisfaction amongst the participating groups. Factors such as good relations with colleagues, training opportunities, and work flexibility were identified to assist with increasing worker satisfaction. Further suggestions for enhancing employees’ job satisfaction are provided.     

Self-Esteem,Life Satisfaction,and Positive Future Perception among at-Risk and Comparison Group Participants in National Civic Service

ABSTRACT

This study focuses on a program designed to engage at-risk youth in the National Civic Service (NCS) in Israel with the goal of enabling them to better integrate into normative adult lives. This exploratory study employed a cross-sectional design and compared groups of at-risk female volunteers (N = 426) with comparison groups of not at-risk participants in the NCS (N = 456). For both of them, three sub-groups were examined at different stages of their service: the beginning, near the end, and about one year after finishing the service. In both the at-risk and comparison groups, self-esteem was higher among the alumni compared to those at earlier stages of the program. Life satisfaction was generally much lower among the at-risk group, but after service completion, both groups reported higher life satisfaction. There were no significant differences between the groups in their future perceptions. The implications of these findings for policy and practice are discussed.     

老年健康照顾需求评估与个案管理——基于昆明市实证调查

随着社会经济的发展和医疗卫生条件的改善,高龄化及慢性病的快速增长,老年多元照顾的需求使“个案管理”成为中国社会工作急需解决的课题。本文在对昆明市独居、丧偶、空巢及高血压老人做健康照顾需求评估的基础上,就“个案管理”的制度建设及运作,提出“政府主导、NGO（NPO）资源整合、强化老人（家庭、社区）支援”的建议。     

Life Aspirations: Their Impact on Family and Work Conflict and Life Satisfaction in Hong Kong and Taiwan

Family and work conflict (F/WC) has gained prominence in developed economies in Asia as individuals are faced with the increased demands from work and families that are still considered very important. Hong Kong and Taiwan best illustrate the changing social and economic conditions that have given rise to this conflict. In these two societies, people have demonstrated a strong emphasis on work, even when it entails the sacrifice of family tasks and duties. An array of informal and formal services have been mobilized to allow people to fulfill their duties to work and family. Based on surveys conducted in Hong Kong and Taiwan in late 2009, this paper investigated F/WC and life satisfaction. Specifically, it examined changing life aspirations, both material and non‐material, as predictors of F/WC and life satisfaction. The surveys found that respondents had high aspirations for both their family and their work, and for both material and non‐material assets, and that they experienced high‐level F/WC. Based on the statistical analysis, we argue that minimizing the interference of family life on work and emphasizing non‐material life aspirations could promote better life satisfaction.     

Perceived Usefulness and Easiness of Information and Communication Technologies and Volunteering among Older Adults

ABSTRACT

This study investigates the association between older adults’ perception of usefulness and easiness (PUE) of Information Communication and Technologies (ICTs) and volunteering, and if this association differs across their income status. Data were obtained from the 2012 wave of the Health and Retirement Study (HRS), and the sample was restricted to respondents aged between 60 and 84 (N = 901) and who completed the 2012 HRS technology module. Multinomial logistic regression was employed to examine the independent and joint influence of PUE of ICTs and of low-income status on volunteering. The results show that only people with high PUE engaged in more than 100 hours of volunteering among older adults after controlling for covariates. The positive effect of high PUE was found to be more significant in the low-income group. This is the first known research to investigate the PUE of ICTs and volunteering among older adults. This study expands the knowledge of volunteering among older adults by exploring ICTs which can be considered as one of the most influential macrosocial changes in the current society. Moreover, our findings provide some insights and an empirical foundation in volunteering programs for older adults of different PUE levels.     

Disaster Preparedness among Older Adults: Social Support,Community Participation,and Demographic Characteristics

This study examined factors associated with disaster preparedness among older adults, with special attention paid to demographic characteristics, social support, and community participation. From a larger study about disaster preparedness of persons with disabilities, a total of 719 adults aged 55 years and older were used for this study. The results of the logistic regressions indicate that individuals who have higher levels of social support and more connections to community organizations are more likely to be prepared for disaster-related emergency situations. In another model, using resource preparedness as the dependent variable, an interaction effect between social support and income was found. Overall, higher income and higher informal support are related to a higher level of resources for disaster preparedness. However, the relationship between income and disaster preparedness is much stronger for those sub-groups receiving more informal support. The findings of this study expand knowledge regarding issues of disaster preparedness among older adults and demonstrates the importance of social resources and networks. This study suggests an intervention model for decision-makers and community leaders in terms of providing information and advice to members of their communities about how to adequately prepare for natural disasters.     

Adverse Childhood Experiences and Substance Use History among Vulnerable Older Adults Living in Public Housing

ABSTRACT

Previous research shows strong correlations between adverse childhood experiences (ACE) and later life health. The current study examines the relationship between ACEs and substance use among older adults living in public housing. Results show that about one-third of participants had four or more ACEs, and ACE score predicted likelihood of substance use history. Over half of older adults with four or more ACEs experienced substance abuse in their lifetime compared to one out of ten older adults with less than four ACEs. Findings shed light on a vulnerable group and point to next steps in research and practice.     

Autonomy,Choice and Control for Older Users of Home Care Services: Current Developments in Swedish Eldercare

In Sweden, a policy shift towards more individualized eldercare, with an emphasis on consumer choice, has taken place. The aim of this study was to analyze the processes and practices of individualized eldercare, focusing on preconditions for older peoples’ choice and control. Data consist of qualitative interviews with users of home care services (n – 12) and staff (n – 12) and participant observations (n – 7) of meetings between staff and older people. The choice and control available to older users emerged as decisions about ‘what’ care and services, ‘who’ should provide the care and services, and ‘how’ the care and services should be performed. Three approaches to enable older people choice and control over their home care services were revealed: test and revise, services elaborated in close collaboration between users, care managers and home care staff; choices in the moment, users could choose services at each occasion; and quality improvement through competition, competing providers develop attractive services. The findings could guide policy makers in combining the strengths of these approaches to enable older people in need of support to become co-producers in designing, managing, as well as consuming, care and services. Future quantitative research is needed to achieve generalizable knowledge about the strengths and weaknesses of different ways to organize eldercare services.     

Formal Social Participation and Utilization of Community-based Services among Urban Elderly Chinese Living Alone in Shanghai,China

This research examined formal social participation among elderly Chinese adults living alone and the association between utilization of community-based services and formal social participation, which refers to participation in employment, volunteer jobs, and social groups. Using a secondary analysis on a survey data from a simple random sample of 228 adults aged 60 and older living alone in a Shanghai neighborhood, it was found that only small percentage of older adults living alone were involved in formal social participation. Hierarchical multiple regression analysis showed that use of community-based services is significantly associated with formal social participation among elderly Chinese living alone. Thus, future policies and programs should focus on strengthening community-based services for elderly Chinese, to more effectively promote and facilitate their social participation.