Sense of Need for Financial Support and Respite Services among Informal Caregivers of Older Americans

ABSTRACT

Financial support and respite services are two of the most frequently reported types of help that caregivers of older adults need. Using an expanded health behavioral model, this study examined the effects of predisposing, enabling, and needs factors on caregivers' sense of need for these two types help. Data were drawn from the 1999 National Long-Term Care Survey and included 1,058 caregiving dyads in the community. The results indicated that caregiver-related factors more than care recipient–related factors affected caregivers' sense of need to seek both types of help. The findings direct to two important implications for long-term care policy for and practice with older adults: improvement of service for caregivers and service delivery systems.     

Sexual Coercion,Verbal Aggression,and Condom Use Consistency Among College Students

Abstract

Objective: The relationship between condom use and 2 less visible categories of intimate partner violence (IPV), sexual coercion and verbal aggression, was examined among college students. Methods: In March 2007 a random cross-sectional sample of undergraduates from the southeast region of the United States was taken to collect information about sexual coercion and verbal aggression, in addition to condom use consistency. Alcohol use was also assessed. Results: Of the 142 participants, 31.7% reported being victims of sexual coercion, and 78% reported having verbally aggressive partners. Participants who reported experiencing sexual coercion in their relationship were significantly less likely to consistently use condoms. Additionally, alcohol use before or during episodes of verbal aggression was negatively associated with condom use. Alcohol use was also significantly associated with heightened incidents of coercion and aggression. Conclusions: Results indicate that among college students, the presence of sexual coercion adversely affects condom use, as does alcohol use.     

Elders with Serious Mental Illness: Lost Opportunities and New Policy Options

This article reviews key federal Medicaid policies affecting older adults with serious, long-term mental illness: (a) the Medicaid exclusion of coverage for Institutions for Mental Diseases, (b) the Preadmission Screening and Resident Review Process, and (c) the Medicaid Home and Community Based Services waiver policy. Documenting the incentives and restrictions in these policies provides an historical context for understanding the current gaps in treatment for elders with mental illness. New federal options under the Deficit Reduction Act may provide opportunities for reducing the institutional bias for older adults with mental illness and for improving mental health services for elders under Medicaid.     

Physical Abuse of Older Adults in Nursing Homes: A Random Sample Survey of Adults With an Elderly Family Member in a Nursing Home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.     

Domestic Violence in the Second Half of Life

Providing an adequate and effective community response to women age 50 and older who experience domestic violence is complicated by the oftentimes disparate goals and expectations of service providers, emergency responders, and victims themselves. This article shares information provided by participants of focus groups designed to understand and identify what women age 50 and older want and need from agencies that provide services to enhance victim safety.     

Cultural and Ethical Issues in Korea's Recent Elder Abuse Reporting System

The primary purpose of this article is to examine the relevance of cultural values, such as familism and individualism, that influence public policy implementation processes for protecting older adults in Korea and the United States. The secondary purpose is to identify ethical dilemmas and policy implications for effectively implementing the recently developed public law designed to protect vulnerable older adults in Korea. This article discusses both similarities and differences found in the two countries' elder abuse reporting systems and the service delivery systems for protecting older adults at risk of abuse and neglect.     

Factors Associated with Suicidal Ideation Among Women Abused in Intimate Partner Relationships

This study examines factors associated with suicidal ideation among women abused in intimate partner relationships. Data were collected from the case records of 95 women screened upon in‐person contact with admissions workers in a domestic violence shelter in one Midwestern state. Forty‐three percent of the women reported suicidal ideation as significantly associated with childhood sexual abuse, childhood physical abuse, and adulthood intimate partner abuse lasting fewer than 12 months in duration. The results have policy and practice implications for those interested in the mental health needs of women abused in childhood and adulthood. Implications for research are presented that more precisely identify how the effects of past and current traumatic experiences intersect and contribute to suicidal ideation among women abused in intimate relationships.     

The Psychotherapeutic Dimensions of Clinical Case Management with a Combat Veteran

This article addresses the overlapping dimensions of clinical case management and psychotherapy. The theoretical framework that is used as the basis of analysis is drawn from the work of D. W. and Clare Winnicott. Kanter has more than adequately demonstrated that these two authors were extremely knowledgeable about clinical case management and psychotherapy. The conclusion of the paper agrees with D. W. Winnicott (1961 Winnicott, D. W. 1961. “Varieties of psychotherapy.”. In Home is where we start from: Essays by a psychoanalyst, Edited by: Winnicott, C, Shepherd, R and Davis, M. 101–111. New York: Norton.  [Google Scholar]) who defined clinical case management as a variety of psychotherapy. The shared psychotherapeutic dimensions of clinical case management are identified as a focus on human development, the importance of the facilitating/holding environment and issues related to transference and countertransference.