Planning for Aging in Place: Incorporating the Voice of Elders to Promote Quality of Life

Abstract

Aging in place offers emotional and physical benefits; however, challenges associated with advanced age may make aging in place difficult. As communities across the country prepare for forecasted increases in the proportion of older residents, it is important to understand barriers that may prevent aging in place. Perceived barriers voiced by residents of a suburban county who completed an Aging in Place Needs Assessment Survey were categorized into four themes: need to downsize/home modification; need for assistance; family desire to reciprocate care; and isolation. A fifth group with no intent to relocate, but with concerns about having to, was also identified. Included among this group were persons with mental health or developmental disorders, such as anxiety and autism spectrum disorder. Results were examined through a person-centered lens to illustrate that aging in place may be the desired option even among residents who indicate that it is not. It is important that aging-in-place initiatives preserve identity by fostering a sense of autonomy, control, and well-being in older residents.     

Assessing the Psychometric Properties of Both a Global and a Domain-Specific Perceived Quality of Life Measure When Used with Youth Who Have Chronic Conditions

The purpose of this paper was to assess the psychometric properties of the Students’ Life Satisfaction Scale (SLSS) and the Brief Multidimensional Students’ Life Satisfaction Scale (BMSLSS) when used with youth who have chronic conditions. Baseline data from a longitudinal study examining predictors of changes in perceived quality of life (PQOL) for youth with chronic conditions were used. SLSS and BMSLSS data were collected on over 400 youth aged 11–17 using youth self-report and parent proxy-report versions. Internal consistency, convergent validity, and factor structure were examined for both versions. Extent of agreement and magnitude of differences between youth and parent report were evaluated. Finally, gender, age, and condition group differences in youth report scores were examined for the SLSS and BMSLSS. Strong internal consistency was demonstrated for the youth and parent reports of both measures. As with normative samples, a single factor structure was found for youth and parent reports of the BMSLSS. However, both youth and parent reports of the SLSS had a two-factor structure: one consisting of five positively worded items, and the other, two negatively worded items. Youth reported their PQOL to be significantly higher than did their parents. Significant differences in PQOL scores for the youth report were not found by age, gender, or conditions. Findings show that, from a psychometric standpoint, the BMSLSS (both youth and parent report) is a promising measure of PQOL for use in population-based research with youth who have chronic conditions. The SLSS may need to be revised to exclude negative items when used with this population of youth.     

Who decides the position for birth? A follow-up study of a randomised controlled trial

BackgroundPhysical benefits are suggested for women and their babies when women adopt an upright position of their choice at birth. Available care options during labour influence women's impressions of what intrapartum care is. This indicates that choice of birth positions may be determined more by midwives than by women's preferences.QuestionThe aims of this study were to investigate factors associated with adherence to allocated birth position and also to investigate factors associated with decision-making for birth position.MethodAn invitation to answer an on-line questionnaire was mailed.FindingsDespite being randomised, women who gave birth on the seat were statistically significantly more likely to report that they participated in decision-making and that they took the opportunity to choose their preferred birth position. They also reported statistically significantly more often than non-adherers that they felt powerful, protected and self-confident.ConclusionsMidwives should be conscious of the potential impact that birth positions have on women's birth experiences and on maternal outcomes. Midwives should encourage women's autonomy by giving unbiased information about the birth seat. An upright birth position may lead to greater childbirth satisfaction. Women's experience of and preferences for birth positions are consistent with current evidence for best practice.     

Subjective Versus Objective Definitions of Homelessness: Are there Differences in Risk Factors among Heavy-Drinking Women?

Investigations with homeless populations have focused on those living on the streets or in shelters; few have examined phenomena based on respondents’ self-definitions as homeless or not. This investigation examined similarities and differences among risk factors (including mental health, substance abuse, religion/spirituality, social support, and risky sexual behaviors) using two definitions of homelessness: one where place of residence defined individuals as homeless (the ‘objective’ or traditional, definition) and another where respondents defined themselves as homeless (the ‘subjective’ definition). Data come from the baseline survey of the NIAAA-funded “Sister-to-Sister” study (n = 339) of heavy-drinking women. Subjectively defined homelessness was associated with higher rates of mental health and substance use disorders, lower rates of condom use, higher rates of trading sex for food, and less social support. Objectively defined homelessness was associated with higher rates of drinking in abandoned buildings, on the streets, and in public restrooms, more new sexual partners, and higher rates of trading sex for heroin and speedballs. Investigations failing to ask for subjective information may misattribute some factors to homelessness which may overestimate the effect of various factors on homelessness. Investigators should ask respondents to define their homelessness, or they lose an important dimension of the concept of homelessness.

The effects of loneliness on telemarketing fraud vulnerability among older adults

Older adults are disproportionately affected by telemarketing fraud, especially those who are socially isolated. Twenty-eight older adult telemarketing fraud victims completed a questionnaire assessing loneliness and other variables related to telemarketing fraud vulnerability. Victims tended to be male, divorced/separated, and college-educated, between ages of 60 and 70. Age and marital status were significantly associated with loneliness. This study is an important first step for additional research in this area and may enhance the prevention and intervention efforts of social service providers who work with older adults who may be most vulnerable.     

Child care for preschoolers: Differences by child’s age

Because of the high rates of employment of mothers, a large and increasing number of preschool children receive regular care from someone else. This article develops and tests hypotheses about the choice of child care arrangements for younger and older preschool children, using data from the National Longitudinal Survey of Young Women. We argue that appropriate care depends on the age of the child. It includes care by the mother or a paid provider in the child's home for children aged 0-2 and mother care and nursery school or center care for those 3-5. We estimate models of the mother's employment and choice of child care separately for younger and older preschoolers. Our results show that need for care, presence of substitutes for the mother, financial resources, and preferences all affect both full-time care by the mother and the type of child care chosen by working women, although they affect these two decisions in different ways.     

The changing influence of religion on U.S. fertility: Evidence from rhode Island

Traditionally one of the indisputable generalizations in demography has been that Catholics have higher fertility than Protestants and Jews (Freedman, Whelpton, & Campbell 1959; Ryder & Westoff 1971; Westoff, Potter, & Sagi 1964; Whelpton, Campbell, & Patterson 1966). Recently, however, doubts have been raised about the continued validity of this longstanding and heretofore widely accepted generalization.     

Timing of the transition to nonvirginity among unmarried adolescent women

This article focuses on differences between teenagers who became sexually active in early adolescence (15 or younger) and those who did so in late adolescence (16–19). It reviews research on adolescent sexual behavior and summarizes findings on factors associated with adolescent coitus. The few findings on the meaning of first coitus are also noted. A study which used a sample of already-pregnant adolescents is presented in detail. While few differences between those who first had coitus during early adolescence and those who had it later were significant, most were in the predicted direction, and none were contrary to the hypotheses. A major significant difference concerned the relationship between sex and love; those who found the two related tended to start their sexual careers later than those who did not. Policy implications of research findings are discussed, especially those relevant to sex education.This research was supported in part by Grant No. HD 11099 NICHD, and in part by Grant No. 78-499, Charles Stewart Mott Foundation.This article is a revision of a paper presented at the Annual Meetings of the Society for the Study of Social Problems, August 26, 1980, New York, N.Y.