A profile of support group use and need among middle-aged and older adults with multiple sclerosis

This study compared middle-aged and older adults with multiple sclerosis (MS, N = 1,275) according to their use of support groups and identified factors associated with perceived need. Over 64.6% (n = 824) of participants had attended a MS support group meeting at least once. Individuals who had never attended a group were more likely to reside in urban or suburban communities, report lower symptom interference, and fewer activity limitations. Women, individuals without a helper, and people with greater symptom interference were more likely to perceive a need for a support group. Findings raise questions for professionals involved in developing and implementing multiple sclerosis support groups.     

Familial caregivers of older adults

Caregivers of older adults face many obstacles as they balance family, career, and caregiving demands. Caregivers are at an increased risk for burden, stress, depression, and a variety of other mental and physical health complications. It is not uncommon for caregivers to receive some form of pharmacological therapy to treat the physical and mental health changes that may occur throughout their caregiving career. However, while pharmacological forms of treatment are invaluable, medications only may not be sufficient to treat the needs of caregivers. As such, geriatric professionals also have a responsibility to intervene with caregivers through psychosocial interventions. This paper provides an overview of caring, a summary of evidence-based psychosocial interventions for family caregivers of older adults, and recommendations for future interventions.     

Senior centres in the lives of older Americans: implications for Chinese older adults

As a critical community resource, the senior centre has provided older Americans with a wide array of recreational, nutritional, health, and social service programmes. Funding resources include the Older Americans Act allocations, local organisations and governments, national charities, voluntary associations, and religious associations. The types of programmes offered at a senior centre reflect two models: social agency model or voluntary organisation model. The five most popular programmes are nutrition, health and fitness, recreation, volunteering, and social services. Participation in senior centre activities has positive impacts on the overall well-being of older adult participants. With the rapid growth in the ageing population and improved life expectancy in China, senior centres may serve as a focal point for Chinese older adults by providing a broad spectrum of social services to enhance the well-being of community-dwelling older adults, to support their independence and dignity, and to facilitate ageing in place in later life.     

Medication management and adherence among cognitively impaired older adults

This study examined the relationship between patients' cognitive status, deficit awareness, medication management skills, and actual medication adherence. Twenty-seven persons with Alzheimer's disease and 20 healthy controls were evaluated for their predicted and objective performance on tasks related to medication management. Caregivers were also evaluated for their prediction of the care recipient's management abilities. A pill count was taken at the initial interview and 30 days later. MMSE and deficit awareness were related to amount of help received from a family member, suggesting that caregivers tend to accurately assess their relatives' medication management abilities. Adherence rates were acceptable, but some intervention strategies selected by caregivers were not effective in assuring adequate adherence. Additional study is needed to determine the effectiveness of various strategies adopted by informal caregivers.     

Keyworkers Re-examined: Good practice, quality of care and empowerment in residential care of older people

Correspondence to Rosemary Bland, Department of Applied Social Science, University of Stirling, Stirling FK9 4LA, Scotland Summary Social work definitions of ‘good practice’ in residentialcare which were originally developed in work with children andyoung people have also been applied to residential settingsfor other user groups, including older people. However, anylink between such elements of practice and positive outcomesfor users has not always been demonstrated. The introductionof market principles and orientations into social welfare inthe 1980s re-defined the social work ‘client’ asa ‘consumer’ with the associated power to make choicesin the area of social care. The success with which such an approachcan be applied to services for people who are very often, notin a position to exercise much choice, is debatable. Alongsidethe notion of the ‘consumer’ or ‘user’of services has grown the ideology of ‘empowerment’of people who use social work services. Drawing on findingsfrom a recent study, this article explores the contributionof the keyworker role to good practice and the empowerment ofolder people living in residential homes. It concludes that,because their understanding of the concept and practice is largelyundeveloped, the role as currently interpreted is not consonantwith good practice and tends rather to reinforce the power ofstaff.     

Overview of evidence-based practice with older adults and their families

Over the past decade, there has been tremendous growth in the movement to enhance the delivery of quality services through the use of evidence-based interventions. While a growing number of reviews have examined the effectiveness of pharmacological interventions for older adults, few have examined the status of psychosocial interventions for the older population. The purpose of this special volume is to increase researchers' and practitioners' knowledge of evidence-based treatments for older adults and their family members. To this end, a thorough review of the extant research on psychosocial interventions available to address the varied health, mental health/cognitive, and social role challenges faced by older adults and family caregivers is provided.     

Hip Hop,empowerment, and clinical practice for homeless adults with severe mental illness

This article focuses on the use of a music and empowerment-based group as a vehicle for engagement, and therapeutic, and social-emotional benefits with homeless adults coping with severe mental illness in a shelter setting. The authors present a conceptual framework that includes case illustrations to capture the group process. The group was guided by the MUZUZE Hip Hop and empowerment framework, which is meant to facilitate well-being as evidenced by indicators of social-emotional learning and empowerment-based positive youth development. The authors found that the use of Hip Hop helped foster well-being via pathways of individual and community empowerment. Implications for future research and practice are discussed.     

Living on the margins: older homeless adults in Toronto

A handful of scholars have acknowledged that, along side the traditional homeless, there are now older people who become homeless for the first time in old age. Few researchers, however, have systematically compared the recent older homeless with the chronic or traditional homeless. In the research presented here, we compare recent older homeless with long-term older homeless adults in Toronto according to their health and wealth, their housing history, and their use of health and social services. Findings indicate that people who become homeless for the first time at older ages have needs that are different from the lifetime elderly homeless and require different approaches to intervention.     

Perceived benefits of VFW post participation for older adults

Older adults, as active members of the Veterans of Foreign Wars (VFW), describe multiple benefits of participation in the organization to their overall well-being. This qualitative study examined the perspectives of 20 active participants of a VFW Post and its Ladies Auxiliary. Findings indicate that, for the study participants, the VFW serves as a primary source of cross-generational influence, emotional support, and meaningful activity and provides a safe and secure environment for members. This article provides valuable information that social work researchers and practitioners can use to help increase older adults' civic engagement and address service gaps.     

Voices of resilience: older adults in hospice care

Terminally ill older adults have the capacity to live well in the context of dying. Having negotiated a lifetime of challenges, they have resources to demonstrate resilience and achieve wholeness in life's final phase, but research has not adequately investigated this process. This qualitative research study considered the paths to resilience used by 30 older adult hospice clients in Kansas and Illinois. Responses were coded using the grounded theory method of Strauss and Corbin (1990) where data drives interpretation and text is coded into categories. Results centered on four themes that included: (1) a redefinition of self; (2) use of religion/spirituality or openness to uncertainty; (3) maintenance of social investments; and (4) guarding independence even as the scope of life contracted. Results imply that attention should be paid to building environments of wellness. This may be accomplished paradoxically through facilitating continuity of client interests and yet opportunities for creativity and growth as well. Listening with a healing stance and cultivating a habit of being fully present in interactions with clients assist in this process.     

Immigration,living arrangement and the poverty risk of older adults in Hong Kong

Using 2011 census data, this study investigated how living arrangement affects disparities in poverty between older adults (aged 65 and older) who migrated to Hong Kong from Mainland China and those who were born in Hong Kong. Our sample consisted of 29,987 immigrants and 9,398 natives, all of whom were ethnic Chinese and living in Hong Kong at the time of the census. We found higher poverty rates among older immigrants than among natives, a disparity that persisted even after adjusting for living arrangement, human capital characteristics, assimilation‐related variables, household composition and demographic characteristics. We also found that living arrangement moderated the impact of immigrant status on the poverty risk among older adults, and that the impact was due mainly to the number of earners in the household. The implications of our results with respect to poverty among older adults and anti‐poverty measures are discussed.     

Religion and coping in older adults: a social work perspective

Religion is an important coping resource for many older adults. This paper briefly describes social work's religious roots, makes a distinction between religion and spirituality for older adults, and presents empirical data showing how older adults employ religious strategies to cope with life challenge. The study reports on religious coping in an available sample of 79 European American and African American older adults residing in urban community dwellings. Implications suggest how social workers and others may support religious coping.     

Longitudinal causal relationship between depression and self-esteem in Korean older adults

This study aimed to examine the longitudinal causal relationship between depression and self-esteem (SE) in older Koreans and analyze gender differences in this correlation. Participants were 4742 older adults aged ≥65 years in baseline 2018 from the Korea Welfare Panel Study. Depression and SE were measured every year from 2018 to 2021. This study estimated causal relationships using the autoregressive cross-lagged model and analyzed gender differences using a multigroup approach. The findings indicate that depression and SE in older adults support the reciprocal causal model, but there are no gender differences. The study recommends that both depression and SE should be considered in the design of social work intervention programs for older adults but can disregard gender differences.     

Ethical and psychosocial issues raised by the practice in cases of mistreatment of older adults

Intervention regarding older adult mistreatment raises many questions for practitioners. They have to interact with the victim, the abuser, and, in many cases, with both of them at the same time. In such cases, five themes emerge from the literature review on psycho-social and ethical issues in practice: practitioners' pre-construction and axiological frameworks, victims' capacity, confidentiality versus collaboration between practitioners or between agencies, social and family responsibilities and the balance between competing values in practice. Practitioners are well placed to offer a critical reflection on their practice and on ways of improving it. The goal of our qualitative study is to identify issues and ethical dilemmas in elderly mistreatment situations as represented in the discourses of practitioners in reference to interventions in their psychosocial practice. Sixteen practitioners from the public and community (non-profit organization) sectors were interviewed using a practice history approach. This paper presents the main ethical and psychosocial issues raised by practitioners and some ideas to improve the practice. It is motivated by the crucial question haunting the practitioners' minds: "How far should we go?"     

An exploratory study of substance abuse among Latino older adults

Substance abuse among older adults is on the rise. Of particular concern is the increase in alcohol and drug use predicted among Latino elders, expected to result from an upsurge in the Latino population and concurrent growth in the number of older adults. Providing effective treatment for this group will require age-specific, culturally competent interventions. However, few studies have focused on geriatric substance abuse among Latinos. This study aims to lay the groundwork for further research by examining perceptions of the problem among treatment providers and researchers in aging and substance abuse. Implications for social work research and practice are addressed.     

The performance of the income protection system for older adults in Ecuador and future challenges

The objective of this article is to analyse the performance of Ecuador’s pension system and the challenges it will face in the future. Over the last 13 years, the pension system has made significant advances in terms of coverage and adequacy. However, demographic ageing is straining the financial sustainability of the contributory scheme. In this context, a number of public policy areas are identified, in terms of parameters and structures, which, together with the expansion of non-contributory coverage, could provide a more equitable and sustainable scheme.     

Subjective experiences of older adults in poverty in urban China and the role of social policy

This study establishes an evidence base regarding the experiences of older adults living in poverty in Beijing. Given the factors that shape the lives of low-income older adults, the findings are relevant for many middle- and low-income countries. Based on a series of in-depth interviews conducted with government officials and low-income older adults in Beijing, the study finds that poverty manifests as cumulative stress arising from four sources: financial strain, poor health, care burden and poverty-related shame. This stress is attributable to the co-existence of individual and structural factors that reflect the framing of anti-poverty policies in China.     

Present and prospective health status of older adults in the Philippines: The role of education

Utilizing current information to project prospective ill health prevalence can help prepare the country to ensure the well-being of older people. The prevalence of ill health in terms of physical, psychological, and cognitive health dimensions was estimated by age, sex, and education attainment level using the 2018 Longitudinal Study on Aging and Health in the Philippines. Subsequently, the said rates were integrated into population projection estimates from 2020 to 2080. It was observed that the depression prevalence rate among older people was highest at above 40%, while physical and cognitive limitations were at around 18% and 22% respectively. It was also found that prevalence rates of ill health increased with age and that ill health was more prevalent among women than men, particularly at more advanced ages. The use of population projections has shown that education differentials in the analyses estimate lower prevalence rates of ill health for both sexes. The findings provide estimates for the prospective care needs of the older population in the Philippines. It was also suggested that education may possibly have preventive effects on ill health. Utilizing present information in order to prepare for issues can be beneficial for securing the well-being of older adults.