Hardiness,Successful Aging,and HIV: Implications for Social Work

ABSTRACT

With dramatic developments in the treatment of HIV/AIDS, life expectancy is increasing, resulting in more middle-aged and older adults living with this disease. Little is known about the problems, and especially the strengths, of those living and aging with HIV. Hardiness is used in the gerontological literature to describe and explain how people age successfully, despite traumatic life events and chronic diseases. Similarly, the concept of hardiness may be used to guide clinicians, researchers, and clients on how to age successfully with HIV. This article provides a review of hardiness in aging and HIV, and emphasizes its importance in facilitating successful aging with this disease. Conceptual and methodological concerns in studying hardiness and successful aging are addressed. Potential interventions and clinical implications for social work are posited for augmenting qualities of hardiness in people aging with HIV.     

Clinical Social Workers Knowledge About Aging:

This study explores clinical social workers' knowledge about old age using Palmore's (1977) "Facts on Aging" quiz to measure knowledge about persons 65 years of age and older. Data are based on a mailed questionnaire completed by 200 MSW social workers from the state of Ohio who were listed in the NASW 1976 Register of Clinical Social Workers. Key findings are as follows: (1) the average number of corret responses on the facts quiz is 17 (68% correct); (2) examination of the items which 60% or less of the respondents answered correctly reveals five items that indicate a negative bias toward the elderly, three items a positive bias, and two which are neutral; and (3) rank order of the content areas in which items are most often missed indicates sociology of aging and demography of aging are the two areas where knowledge is most lacking. Implications for graduate education and in-service training for clinical social workers are discussed.     

Physical and mental health changes in aging foster parents: Do child behavioural problems hasten declines?

This study examined foster parent physical and mental health over time. It was hypothesized that increased severity and frequency of child behavioural problems, whether externalizing or internalizing, would be associated with poorer health over time, especially for foster parents ≥60 years of age. Data from the baseline and Wave 2 interview of the 2010 National Survey of Child and Adolescent Well‐Being were used. The final analytic sample included kin and nonkin foster parents who had custody of a foster child for both waves of data collection (n = 962). Ordinary Least Squares regression models with lagged dependent variables showed that foster parents ≥60 had deteriorating physical health over time, but caregiver age alone had no association with worsening mental health. However, parents ≥60 caring for children with externalizing behavioural problems had significantly improved physical health. Mental health of parents ≥60 significantly diminished if child externalizing or internalizing problems worsened. Findings indicate that for aging foster parents, externalizing child behaviours may stimulate physical activity and improved physical health, yet any type of child behavioural problem can deteriorate mental health functioning.     

Social Support,Retirement Resources,and the Gendered Experiences of Aging for Tunisian Older Adults

Cultural context plays an important role in the experience of aging. The country of Tunisia is of particular interest because limited studies on aging have been done in the past decade. The study examined data collected from Tunisian older adults in an attempt to gain additional information about their experience aging in this culture. The purpose of this study was to identify key information tied to social policy factors that have the potential to impact older adults living in Tunisia. From June to July 2017, semi-structured interviews were completed with 60 older adults covering topics about family history, daily activities, health and health satisfaction, retirement benefits and satisfaction, medical coverage, social support, service availability, feelings of growing older, as well as advice provided to younger adults. Findings include gender differences in retirement resources and benefits, sources of support, and older adults’ self-reported desires for the future. This work adds to the growing body of literature concerning differences in global aging and provides greater awareness of aging in the distinctive context of Tunisia. Additional work should seek to deepen the investigation of the various social policies that impact the Tunisian older adult.     

A Pastoral Understanding of Positive Aging

Abstract

Positive aging may be more dependent on spiritual well-being than physical capacity. Understanding the spiritual perspective derives from the dichotomy between the “perceptual” and the “spiritual” realms of human awareness. Awareness of spiritual process in relationship to positive aging may also offer counseling additional challenges and opportunities, including: a balanced perspective on life issues, a sense of humor, counter-factual thinking, internal strengths and resources for growing through life losses and crises, and compensation skills that focus on current capacity and chosen pathways rather than dwelling on lost abilities.     

Aging With a Severe Mental Illness: Challenges and Treatments

Severe mental illness (SMI) impacts many different facets of individuals' lives. As they age, those with SMI experience increased physical illnesses, functional impairment, cognitive deficits, and social disability. To promote more effective social work practice with this population, this article highlights the major biopsychosocial and family issues of aging with a psychiatric diagnosis. In addition, intervention approaches that have demonstrated efficacy are summarized along with ways to coordinate services across multiple service delivery sectors. Finally, future directions in practice and research are presented to develop additional methods of support for older adults with SMI and their families.     

Impact of Mid-Life Symptoms of Alcoholism on the Health and Wellbeing of Aging Parents of Adults with Disabilities

The study examined the effect of adult children’s disability on parents’ physical health in later life and the extent to which parents’ symptoms of alcoholism in mid-life moderates the link between children’s disability and later life parental health. Analyses are based on data from the Wisconsin Longitudinal Study. The analytic sample included parents of children with developmental disabilities (n = 145) or mental health problems (n = 200) and 2,432 parents of unaffected children. The results showed that the negative health consequences in later life of having a child with a developmental disability were greater for those who showed more symptoms of alcoholism in mid-life. However, symptoms of alcoholism in mid-life did not significantly moderate the impact of an adult child’s mental health problems on parents’ later life physical health. The findings suggest a potential area where gerontological social workers could intervene, given the negative impact of symptoms of alcoholism on the health of aging parents of children with a disability who may be significantly more susceptible to the negative health impacts of alcohol compared to their younger counterparts.     

Aging with a severe mental illness: challenges and treatments

Severe mental illness (SMI) impacts many different facets of individuals' lives. As they age, those with SMI experience increased physical illnesses, functional impairment, cognitive deficits, and social disability. To promote more effective social work practice with this population, this article highlights the major biopsychosocial and family issues of aging with a psychiatric diagnosis. In addition, intervention approaches that have demonstrated efficacy are summarized along with ways to coordinate services across multiple service delivery sectors. Finally, future directions in practice and research are presented to develop additional methods of support for older adults with SMI and their families.     

Social Welfare Reform Since the 1997 Economic Crisis in Korea: Achievement, Limits, and Future Prospects

Social welfare reform has been implemented in Korea since the 1997 financial crisis. A dominant concern of the reform was on equality and social solidarity. A major means to this end was establishing universalistic social insurance programs like those in developed welfare states. The reform efforts produced some positive results but were not greatly successful. Income polarization and the deteriorating economic status of low-income families have become big social issues. Many low-income families have not gained many benefits from the reformed social security system. The rapid aging of the population is creating an exploding demand for social spending, risking the fiscal sustainability of major social insurance programs. The reform experience suggests that a social welfare system based on western-style universal social insurance may be too expensive to sustain and not very effective in protecting disadvantaged families in Korea. More attention is being paid to expenditure control and efficiency. Social insurance programs may need to be leaner than those in traditional welfare states. Targeted programs, such as the "making work pay" policy, are likely to be expanded more broadly to low-income families. The future of the Korean welfare state may hinge on successful employment support for working families and extensive investment in their human capital.     

Rules for Aging

In qualitative interviews and focus groups, older informants articulated "rules" for aging, Lhat is, principles for responding to age-related changes. Analysis of these rules distin- guished three basic types: those advocating resistance to aging; those urging acceptance and accommodation; and those encouraging con- lrol of one's thinkine: to sidesteo oainful reactions lo chanee and loss. Each type implies different assumptions about old age.     

The Forgotten: Dementia and the Aging LGBT Community

Although research documenting the experience of lesbian, gay, bisexual, transgendered (LGBT) aging in general is gaining traction, and literature on dementia continues to proliferate, few articles attend to how dementia affects members of the aging LGBT community. This article reviews the current state of knowledge on the experience of dementia for LGBT older adults, and suggests areas for further research. In addition, it aims to promote social work’s engagement with related disciplines and global dementia care. The article’s ultimate goal is to encourage development of care practices tailored to the experiences, expectations and needs of older LGBT individuals affected by dementia.     

A New Neighborhood Every Fall: Aging in Place in a College Town

Older adults who live in residential neighborhoods adjacent to college and university campuses have a unique experience that makes them vulnerable to marginalization and displacement. As these neighborhoods become increasingly dominated by college students living in rental properties, older adults find themselves in the minority in a neighborhood where they have lived for many years. In addition, these neighborhoods are attractive to universities, city governments, and private companies for their development potential, which can result in gentrification. A year-long ethnographic study of a campus-adjacent neighborhood in a small US college town that is home to a medium-sized public university sheds light on the relationships between members of 5 stakeholder groups that have a vested interest in the neighborhood. The study highlights the need for additional research on different types of neighborhoods and their effects on aging in place in addition to outlining social work interventions in campus-adjacent neighborhoods that are designed to enhance these intergenerational spaces.     

An Ecological View of Aging

A transactional view of aging highlights the need for attachments throughout the life course. It emphasizes the environment, its supports, its nutritive and non-nutritive or noxious qualities as critical to our understanding of the aging process. This article discusses the aging process from an ecological perspective. It includes an exploration of theoretical developments and service delivery needs. It also provides a case example of a homeless 75-year-old woman to illustrate the dehumanizing gaps in our service delivery systems that make the consolidation of sense of ego integrity an unlikely outcome.     

人口老龄化背景下的社区养老服务

人口老龄化的趋势不断加快是当前人口发展的态势,在传统家庭养老功能趋于弱化的同时,如何有效地建立满足老年人需求的服务体系是老年工作面临的挑战之一。本文结合老年人的身心特点阐述了社区养老服务的内涵及优越性,在分析了社区养老服务的现状及问题的基础上,提出了社区养老的发展思路和建议。     

Nonmarried Aging Parents' and Their Adult Children's Characteristics Associated with Transitions Into and Out of Intergenerational Coresidence

Abstract

Using data from the 1993-1995 waves of the Asset and Health Dynamics among the Oldest Old (AHEAD), this study focuses on analyzing elderly parents' and their children's characteristics associated with the transitions into and out of intergenerational coresidence. Multinomial logistic regression results show that transition into coresidence was primarily initiated by the parents' old age and deteriorating health and/or health-related crises. Transition out of coresidence into parents' institutionalization was also likely to have been triggered by the parents' health problems. In addition, other things being equal, divorced/separated or never-married parents were more likely but African American and Hispanic parents were less likely to have moved into an institution over a 2-year period. Children in the newly coresiding pairs and those of institutionalized parents were more likely to be married than children in the continuously coresiding pairs. The implications of these within-group differences for social work practice are discussed.     

人口老龄化与养老保障政策应对研究——基于多元社会政策建构视野

人口老龄化趋势是我国人口结构转变的一个突出现象。人口老龄化问题的突现,势必对养老保障压力提出了新的挑战,同时也会影响国家对养老政策的调整。本文基于＂人口年龄结构—国民经济因素—社会因素—养老政策＂综合分析模型,提出了养老保障政策分析的框架。本文以人口结构转变为切入点,描述了人口老龄化趋势,以及由此引发的国家系统养老保障以及公民社会养老保障挑战。为应对这些挑战,本文基于综合分析模型和现代国家治理结构特点,提出了相应的应对策略。本文认为,只有整体性福利制度构建,才能确保在国民经济发展、人口老龄化趋势与社会稳定之间取得动态平衡。     

Awareness of Resources for Visually Impaired Older Adults Among the Aging Network

Approximately 13% of the older adult population have severe near, intermediate and/or distance vision impairment. However, there is little recognition within the aging network that vision impairment among older adults can lead to isolation and excess disability. This article reports on a survey conducted by the Lighthouse National Center for Vision and Aging of the State Units on Aging (SUA) and Area Agencies on Aging (AAA) to assess their awareness of the vision rehabilitation network of services, their perceived need for more information on age-related vision loss and to identify specific projects known to or within the aging network addressing the needs of visually impaired older adults. Among the 298 respondent AAAs, 74% could identify at least one resource for visually impaired people, usually a segregated service offered exclusively to blind/visually impaired older adults. Eighty-three percent of the AAA respondents felt they needed to have more information on age-related vision impairment. The sparsity of programs within the aging network to address needs of visually impaired older persons is documented and discussed.     

Models of the Aging Self

Older adults are faced with numerous physical, psychological, and social role changes that challenge their sense of self and capacity to live happily. In addition, they are inundated by our youth-oriented culture with negative ageist stereotypes. Nevertheless, most older adults live happy, fulfilling lives. In this article, we review theories of the aging individual that address this apparent paradox. These theories can be largely divided into those that emphasize control and goal attainment, and those that emphasize the self's organizational capacity. Of the self-oriented theories, we will highlight Whitbourne's (1996) identity process perspective, which is specific to the aging process and attempts to explain the self's unique capacity to remain stable yet change over time.     

Interdisciplinary Geriatric Education

There is an absence of adequately trained social workers to meet the health and social service needs of a rapidly increasing aging population. Educators face the challenge of helping social workers in the field both to upgrade their gerontological knowledge and skills and to become functioning members of the emerging modality-the interdisciplinary care team. A historical review of gerontological social work education suggests that 'first generation' education programs based on a medical model of intervention gave way to the 'second generation' in which aging was viewed as a normative step in the life cycle. Currently gerontological social work education is entering the 'third generation' in which emphasis is on working with members of other disciplines to provide comprehensive care. This interdisciplinary geriatric health care is most readily taught as a continuing education, postgraduate experience. This 'third generation' of gerontological social work education is exemplified by the experience of the Hunter/Mount Sinai Geriatric Education Center. Interdisciplinary geriatric health care requires teaching by an interdisciplinary team and, to be effective, educators must themselves be equipped to function as member of the team. Barriers to interdisciplinary understanding and the factors necessary for interdisciplinary collaboration are detailed.     

日本应对老龄化的措施及对我国的启示

老龄化正在影响世界上越来越多的国家。日本是全球老龄化进程最快、老龄人口比例最高的国家。早在20世纪70年代，日本就已进入老龄化社会。目前，日本已成为超老龄化国家。面对如此严重的老龄化危机，日本采取了一系列措施，取得了一定的成效，他们的经验值得我国借鉴和学习。