Sex life after 65: How does erectile dysfunction affect ageing and elderly men?

Introduction. We report the findings pertinent to the ageing and elderly participants of a population-based study of erectile dysfunction (ED).

Method. We examined the sociodemographic characteristics, self-reported morbidities and responses to the 5-item International Index of Erectile Function (IIEF-5) of participants aged ≥65 years and ≥80 years.

Results. Most (73%) participants were married or had partners. Among the participants aged ≥65 years, the prevalence of ED (IIEF-5 scores <22) was 67% and of severe ED (IIEF-5 scores <8) 48%. About 32% were sexually active, and 11% had regular sexual intercourse. Cardiovascular disease (CVD) was reported in 37% and diabetes mellitus (DM) in 13%, with odds of ED at 3.91 and 4.68, respectively. Among those aged ≥80 years, the prevalence of ED was 68% and of severe ED 57%. About 12% were sexually active, and 3% had regular sexual intercourse. CVD was reported in 44% and DM in 11%, with corresponding odds of ED at 2.55 and 2.90.

Conclusions. Most ageing and elderly men are in a relationship and many are sexually active. ED is prevalent and severe. Morbidities are common and significantly associated with ED, impairing the sex lives of affected men.     

Patient-Centered Approach to Building Problem Solving Skills Among Older Primary Care Patients: Problems Identified and Resolved

This article describes problems identified by older primary care patients enrolled in Problem Solving Therapy (PST), and explores factors associated with successful problem resolution. PST patients received 1 to 8, 45-min sessions with a social worker. Patients identified problems in their lives and directed the focus of subsequent sessions as consistent with the steps of PST. The 107 patients identified 568 problems, 59% of which were resolved. Most commonly identified problems included health related issues such as need for exercise or weight loss activities, medical care and medical equipment needs, home and garden maintenance, and gathering information on their medical condition. Problems identified by patients were 2.2 times more likely to be solved than those identified by a health care professional. Using PST in primary care may facilitate patients in addressing key health and wellness issues.     

For the Sake of their Health: Older Service Users' Requirements for Social Care to Facilitate Access to Social Networks Following Hospital Discharge

Facilitating older service users’ requirements for accessto or re-engagement in social networks following hospital dischargeis recognized in social care analysis and policy as criticallyimportant. This is because of the associated benefits for restoringphysical health and psychological well-being. However, it tendsto be a neglected dimension of current social care/intermediatecare. Our paper draws on a qualitative study of voluntary sectorhospital aftercare social rehabilitation projects in five UKlocalities, which focused on addressing this issue. Throughexamining older service users’ feedback and experience,our study confirms the health benefits of social care facilitatingaccess to social networks at this crucial juncture. By providingsensitive interpersonal interaction, advocacy and ‘educational’assistance, social care workers supported older service users’re-engagement in a variety of networks. These included friendship,recreational and family groups, health care treatment programmesand locality based contacts and organizations. As a result,material, interpersonal and health care resources were accessed,which contributed to restoring and sustaining physical healthand psychological well-being. The process of such social carealso emerged as critical. This included ensuring that objectivesreflected service users’ priorities; integrating ‘low-level’home care; offering befriending; and challenging the pre-settime frame of intermediate care.     

Participatory research meets validated outcome measures: Tensions in the co‐production of social care evaluation

Funding for care service research is increasingly subject to the satisfaction of two requirements: public involvement and adoption of validated outcome tools. This study identifies competing paradigms within these requirements and reveals significant challenges faced by researchers who seek to satisfy them. The focus here is on a study co‐produced between academic researchers and people with experience of adult social care services. It examines to what extent research studies can conduct high‐quality public involvement and genuine co‐production of knowledge, whilst attempting to produce quantifiable outcome scores. Findings add to debate around how to incorporate diverse perspectives in research, which may draw on incommensurate accounts of validity and reliability. Findings also highlight constructive attempts by academic and co‐researchers to make the combination of approaches work in the field. These small scale acts of researcher agency indicate some scope to combine the two approaches in future research studies. However, conclusions foreground the importance of broader awareness of how tensions and power imbalances related to this combination of approaches play out in social policy research practice.     

Identity,selfhood and dementia: messages for social work

Dementia has been identified as a policy priority area for the European Union (EU). Given projected figures on the global increase in dementia over the next few decades, working with people with dementia is likely to become an even more prominent area of activity for social workers in older people's services. Recent research has begun to engage with the subjective experiences of people with dementia and there is considerable focus within nursing literature on their active efforts to maintain identity and selfhood. However, these issues have received little attention within the domain of social work. This paper reviews recent research on the subjective experiences of people with dementia and discusses the implications for social work in relation to: early intervention; communication and assessment, and support arrangements. Based on experience in England, it is argued that the current policy and practice context constrains social work's ability to respond to these issues and that a supportive organisational context, as well as high levels of skill, time and commitment, are required if concepts of personhood and citizenship are to have meaning in practice.     

Teaching Note—Teaching Intersectionality: Transforming Cultural Competence Content in Social Work Education

Intersectionality has been gaining momentum among social workers as a framework to allow a fuller understanding of the complexity of diverse social identities and the impact of social structures on power, privilege, and oppression. However, the application of intersectionality to teaching in social work education has been relatively absent in the literature. This article describes a 3-hour graduate-level classroom exercise designed to increase knowledge and proficiency of intersectionality. Critical self-reflections of the participants’ experiences are provided to illustrate the evolving growth and awareness that can result from the educational process using this framework. Examples and suggestions for reading assignments and classroom activities are offered. Implications for social work education and future directions are discussed.     

Gender and Clinical Pharmacy: The Career of an Occupational Ideology*

Cet article étudie le concept selon lequel, dans une profession en mutation, la pharmacie en l'occurrence, les femmes sont les principales personnes à transmettre les valeurs liées à la pharmacie clinique - une idéologic professionnelle prétendument instaurée afin de redonner sa place à la pharmacie dans la hiérarchie des professions. Si on constate la force des convictions des membres de la profession à l'endroit de la pharmacie clinique, on observe également que les femmes ne sont pas les premières à les dèfendre. Ni la socialisation des rapports entre les sexes ni une formation particulière en pharmacie n'ont rendu les femmes mieux disposées que les hommes à l'egard de la pharmacie clinique. Les divergences - et elles sont très importantes - au sein de la profession au sujet de la pharmacie clinique se font sentir selon les différents cadres de travail des pharmaciens et selon l'année d'obtention de leur permis d'exercice. Ce sont plus les lieux de travail que les rapports entre les sexes qui permettent de prévoir les attitudes à l'égard de la pharmacie clinique. Il semble done peu probable que le fait d'équilibrer le nombre d'hommes et de femmes dans un milieu de travail soit de nature à le faire évoluer. Quelle que soit, au départ, la conception des pharmaciennes à l'égard de leur profession, elle influe peu sur leur rapport à la pharmacie clinique. This paper explores the idea that in a changing profession, women are the principal value carriers of clinical pharmacy—an occupational ideology professedly developed to restore pharmacy's precarious standing in the occupational hierarchy. While the investigation uncovers considerable evidence for the vitality of clinical pharmacy beliefs among practitioners, women were not at the forefront of this trend. Neither general gender socialization nor specific pharmacy training has rendered females more sympathetic to clinical pharmacy than males. Differences within the pharmacy community regarding clinical pharmacy—and they are quite considerable— emanate from the varied work settings that practitioners occupy and their year of licensure. Attitudes to clinical pharmacy are better predicted by workplace than by gender. On the basis of our findings, it seems unlikely that balancing the number of men and women in an occupation or work organization will, in and of itself, change it. Whatever distinctive prior orientations to work that female pharmacists may hold, they have little impact upon how they think about clinical pharmacy.     

Can a Unified Service Delivery Philosophy Be Identified in Aging and Disability Organizations? Exploring Competing Service Delivery Models Through the Voices of the Workforce in These Organizations

Services for older adults and younger people with disabilities are increasingly merging, as reflected in the creation of Aging and Disability Resource Centers (ADRCs). Using ADRCs to coordinate services is challenging, primarily because these fields have different service delivery philosophies. Independent Living Centers, which serve people with disabilities, have a philosophy that emphasizes consumer control and peer mentoring. However, the aging service delivery philosophy is based in a case management or medical model in which the role of consumers directing their services is less pronounced. Using institutional logics theory and a qualitative research design, this study explored whether a unified service delivery philosophy for ADRCs was emerging. Based on focus groups and questionnaires with staff from ADRCs, findings revealed that competing service delivery models continue to operate in the aging and disability fields.