Perceived Challenges to the Sustainability of Community-Based Aging Initiatives: Findings from a National Study of Villages

Concerns have been raised regarding the sustainability of Villages, a rapidly-expanding set of organizations that typically use a participant-directed approach to improve older adults’ quality of life and ability to age in place. Using online survey and telephone-interview data from a 2013 follow-up study of Villages across the United States, this study examined organizational leaders’ perceptions of the major challenges to sustainability. Major challenges identified included: (a) funding, (b) membership recruitment, (c) leadership development, (d) meeting members’ service needs, and (e) limitations of the Village model itself. Findings point to a number of important considerations for the development, implementation, and sustainability of the Village model, including the role of social workers in addressing these challenges.     

Elders' Decisions To Enter Assisted Living Facilities: A Grounded Theory Study

ABSTRACT

The purpose of this qualitative study was to develop a substantive theory of elders' decision-making process to relocate to an assisted living facility. The researchers interviewed a purposive sample of 28 elders who resided in assisted living facilities. The theory of elders' decisions to relocate to an assisted living facility is a story about elders weighing and balancing gains and losses to go to where the help is. Decision makers weigh and balance gains and losses before, during, and after relocating to an assisted living facility. Elders stay at their current residence if gains outweigh losses and they relocate if losses outweigh gains. Understanding the process of decision-making in this segment of the population may lead to the development of interventions that can promote positive relocation experiences among elders and increase the effectiveness of their decision-making behaviors.     

Pathways of Adult Children Providing Care to Older Parents

Guided by life course and stress process theory, this study investigated pathways of adult child caregivers' family (caregiving, marital, parenting) and nonfamily (employment) roles. Eight waves of data from the Health and Retirement Study were analyzed for 1,300 adult child caregivers. Latent class analysis provided strong evidence for a 4‐class model of caregivers' role pathways. The four pathways were (a) Not‐Married, Early‐Transition to Not‐Working Caregivers (34%), (b) Married, Not‐Working Caregivers (26%), (c) Married, Late‐Transition to Not‐Working Caregivers (23%), and (d) Married, Not‐Working Caregivers with Coresiding Child (17%). Caregivers' background characteristics and contexts predicted pathway membership. Adult child caregivers have structurally diverse life pathways that have implications for theory, research, and practice.     

An Exploratory Study of Group Therapy for Sexually Abused Adolescents and Nonoffending Guardians

ABSTRACT

Adolescent survivors of sexual abuse frequently report severe trauma, depression, anxiety, and low self-esteem. While cognitive-behavioral group interventions show promise, interpreting efficacy is problematic due to commonly high attrition. This article reports promising exploratory study findings relating to a 12-week multimodal abuse-specific group intervention with a nonoffending parent/caregiver component. Participants (aged 11–16 years) consisted of six adolescents with severe abuse histories, and their caregivers. Participants completed pre-, post-, and 1-month follow-up measures. The results were consistent with the possibility that the program produced clinically meaningful reductions in abuse-related psychological sequelae, the program had excellent face validity with participants, and there were no dropouts.     

The Relationship Between Perceptions of Response to Disclosure of Childhood Sexual Abuse and Later Outcomes

This study assessed whether perceptions of others’ reactions to disclosure are related to psychological and physical outcomes among individuals with a history of child sexual abuse. Eighty-six female undergraduates completed a series of questionnaires assessing child sexual abuse, nonsexual trauma, depression, anxiety, posttraumatic stress disorder, somatic symptoms, disclosure, and social reactions to disclosure. Those who reported child sexual abuse endorsed higher levels of psychological and physical symptoms than those who reported a nonsexual traumatic event. Child sexual abuse survivors who reported more hurtful responses to disclosure had higher levels of posttraumatic stress disorder, anxiety, and physical symptoms than nonsexual trauma survivors. These findings suggest that many survivors of CSA may need psychological services, and an important focus of treatment may be assessing and strengthening social support.     

Web 2.0 Technologies: Facilitating Interaction in an Online Human Services Counseling Skills Course

In the face-to-face classroom, human services counseling educators rely on highly interpersonal, interactive methods to teach clinical skills. Replicating these instructional methods in the asynchronous, text-based e-learning environment has been difficult and sometimes impossible. However, web-based technologies, specifically Web 2.0 technologies, may afford educators the opportunity to simulate and enhance the strengths of highly interpersonal and interactive methods of face-to-face clinical skill instruction. These authors demonstrate how a human services counseling skills course can be taught using Web 2.0 technologies. Most of the focus will be on two synchronous applications: 3-D virtual worlds and web conferencing. Implications for educators and recommendations for future research are provided.     

Characteristics of optimum falls prevention exercise programmes for community-dwelling older adults using the FITT principle

This review aims to identify the optimal exercise intervention characteristics for falls prevention among community-dwelling adults aged 60 years and over. Articles for inclusion were sourced by searching the Academic Search Premier, AMED, Biomedical Reference Collection: Expanded, CINAHL Plus, MEDLINE and SPORTDiscus databases with the key words ‘falls’, ‘prevention’, ‘exercise’ and ‘community’ and via reference lists of relevant articles. Only articles of level 1 or level 2 evidence (Howick et al. 2011) were included. Other inclusion criteria included recording falls incidence as an outcome measure, examining a community-dwelling population aged 60 years or over and implementing exercise as a single intervention in at least one group. Exercise programme characteristics from 31 articles were examined according to their frequency, intensity, time and type and their effects on falls incidence were reviewed. Exercising for a minimum of 1 h/week for at least 40 h over the course of an intervention is required to successfully reduce falls incidence. The optimal exercise frequency is three times per week, but the optimal duration per bout remains unclear. Specific balance training of sufficiently challenging intensity is a vital programme component, and strength training is most effective when combined with balance training. Flexibility and endurance training may also be included as part of a comprehensive programme. A combination of group and individual home exercise may be most effective for preventing falls and promoting exercise adherence.