What Are Strategies to Advance Policies Supporting Family Caregivers? Promising Approaches From a Statewide Task Force

Family caregivers are the cornerstone of the long-term supports and services infrastructure in the United States, yet they often contend with many challenges related to this role. Public policy has been slow to change, leaving many caregivers vulnerable to health and economic consequences. Using models of policy making, we identify barriers to advancing policies that support family caregivers and overcome policy drift. We draw on discussions from the California Task Force on Family Caregiving as it prepares state policy recommendations. Identified strategies include identification of caregivers in health care and workplace settings to promote political consciousness raising, collecting and reporting on data that frame caregiving as a policy problem, borrowing policies and language from overlapping fields to emulate their policy successes, and presenting supportive caregiver policies as solutions to other policy problems. By presenting specific strategic approaches to advance caregiving policies, we provide tools to address the growing gap between caregiver needs and policy responses.     

Elder mistreatment in underserved populations: Opportunities and challenges to developing a contemporary program of research

ABSTRACT

This article provides an overview of the status of research on elder mistreatment among underserved populations in the United States, including gaps in our current knowledge base and scientific and structural barriers to growing research on the exploitation, neglect, and abuse of older people from diverse and disadvantaged ethnic/racial, geographic, sexual identity, and socioeconomic groups. High-priority areas in need of new elder mistreatment research with underserved populations are identified, and suggestions are given for how this research can be facilitated by researchers, university institutional review boards, and funding agencies.     

Lessons Learned From a Canadian Province-Wide Age-Friendly Initiative: The Age-Friendly Manitoba Initiative

The Age-Friendly Manitoba Initiative was launched in 2008. A formative evaluation we conducted in 2011 with 44 participating rural and urban communities demonstrates considerable progress, with virtually all communities having formed an Age-Friendly Committee and conducting a community assessment to identify priorities for action. The majority of communities implemented one or more age-friendly projects. Major barriers to becoming age-friendly identified by participants included lack of funding; lack of capacity, particularly in small communities; and lack of leadership or direction. The study highlights the importance of strong leadership at all levels of government (municipal, provincial, federal); the need to support communities, particularly rural ones, as they try to become more age-friendly; and the importance of ongoing promotion of age-friendliness locally and more broadly (e.g., provincially).     

Age-Friendly Portland: A University-City-Community Partnership

This article addresses the question of how creating an age-friendly city has come to be an important policy and planning issue in Portland, Oregon. In 2006, researchers from Portland State University's Institute on Aging examined the meanings of age friendliness among a broad range of participants in Portland, Oregon. The research was conducted in conjunction with the World Health Organization's (WHO) Age-Friendly Cities project and followed the completion of two earlier non–WHO-related projects. The city of Portland, through the Institute on Aging, was one of nine original members to apply for and be accepted into the WHO Global Network of Age-Friendly Cities and Communities. An Age-Friendly Portland Advisory Council was formed to guide the development of an action plan, monitor progress over time, and suggest additional research. To understand how Portland's age-friendly policy effort has developed over time, we use Kingdon's (1984) agenda-setting framework to explain how the policy problem was formulated, how solutions were developed, and the influence of local politics. The policy actors, including individuals and organizations working within and outside of government, are described. The Portland experience provides a case study that other cities, especially those with a strong commitment to community-engaged urban planning, may find useful as they develop age-friendly initiatives.     

Collaborative Partnership in Age-Friendly Cities: Two Case Studies From Quebec,Canada

This article aims to explain the collaborative partnership conditions and factors that foster implementation effectiveness within the age-friendly cities (AFC) in Quebec (AFC-QC), Canada. Based on a community-building approach that emphasizes collaborative partnership, the AFC-QC implementation process is divided into three steps: (1) social diagnostic of older adults' needs; (2) an action plan based on a logic model; and (3) implementation through collaborations. AFC-QC promotes direct involvement of older adults and seniors' associations at each of the three steps of the implementation process, as well as other stakeholders in the community. Based on two contrasting case studies, this article illustrates the importance of collaborative partnership for the success of AFC implementation. Results show that stakeholders, agencies, and organizations are exposed to a new form of governance where coordination and collaborative partnership among members of the steering committee are essential. Furthermore, despite the importance of the senior associations' participation in the process, they encountered significant limits in the capacity of implementing age-friendly environments solely by themselves. In conclusion, we identify the main collaborative partnership conditions and factors in AFC-QC.     

The National Elder Mistreatment Study: An 8-year longitudinal study of outcomes

Objectives: To conduct an 8-year follow-up of the National Elder Mistreatment Study (NEMS) and specify risk ratios for negative outcomes of elder abuse, including DSM-5 defined depression, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and poor self-reported health.

Methods: Attempts were made to re-contact, via Computer Assisted Telephone Interview, all 752 NEMS participants who reported mistreatment since age 60 at Wave I, as well as a randomly selected sample of non-mistreated NEMS participants

Results: 183 NEMS Wave I elder abuse victims and 591 non-victims provided data. In bivariate analyses, elder mistreatment 8 years earlier increased risk of negative outcomes by 200–700%. However, multivariate analyses revealed that Current (Wave II) social support was highly protective against most negative outcomes (excepting PTSD), and even appeared to nullify effects of mistreatment on GAD and poor self-reported health.

Conclusions: Outcomes of elder mistreatment have not been studied prospectively in a national sample. The NEMS 8-year follow-up findings indicate a strong relationship between elder mistreatment at Wave I and negative emotional and physical health 8 years later. Fortunately, current (Wave II) social support appears to be both consistently and powerfully protective against most negative outcomes.     

Prevalence estimates and correlates of elder abuse in the United States: The National Intimate Partner and Sexual Violence Survey

This study examines the prevalence and correlates of psychological abuse and physical abuse against women and men aged 70 or older. Self-report data from 2,185 respondents in the 2010 National Intimate Partner and Sexual Violence Survey (NISVS) were used to create weighted estimates for past-year experiences of abuse. Correlates were then examined using survey logistic regression models. More than 1 in 10 adults who are 70 years of age or older (14.0%) have experienced some form of abuse in the past year, with 12.1% experiencing psychological abuse and 1.7% experiencing physical abuse. One in five victims (20.8%) were abused by both intimate and nonintimate partners. Health care insecurity was the strongest correlate of past-year abuse. The odds of experiencing abuse were 4.53 times greater for those who experienced health care insecurity than for those who did not. This presents a significant challenge for identifying and helping victims of abuse.     

Developing the critical intercultural class-space: theoretical implications and pragmatic applications of critical intercultural communication pedagogy

Teaching intercultural communication presents pedagogical challenges due to the breadth and depth of the discipline and its recent critical turn. Teaching it with a social justice mission, and guiding students to understand critical and postcolonial approaches to its practice, requires complex and multifaceted approaches so as not to oppress or misrepresent marginalised populations. This essay addresses critical intercultural communication pedagogy as a shared system of knowledge among teachers and students, all participants in the cyclical process of learning. Critical intercultural communication pedagogy is presented from a Freirean perspective, as shared ownership of knowledge, including didactic, experiential and reflexive approaches to learning, with educational outcomes that include empathy, connection and ethical responsibilities towards social justice globally and locally. First, several definitions and theoretical perspectives are traced. Next, three short case studies of critical intercultural communication pedagogy (CICP) present varying approaches to teaching critical intercultural issues across diverse populations. Each of the studies is analysed for how the application of different CICP and cosmopolitan pedagogical activities impacts educational outcomes and processes for intercultural students. Finally, several recommendations are given for future scholarship, along with a concluding remark that describes the work’s contribution to critical intercultural communication pedagogy and to the discipline as a whole.