Families,social life,and well-being at older ages

As people age, many aspects of their lives tend to change, including the constellation of people with whom they are connected, their social context, their families, and their health—changes that are often interrelated. Wave I of the National Social Life, Health, and Aging Project (NSHAP) has yielded rich information on intimate ties, especially dyads and families, and on social connections generally. Combined with extensive biological and other health measures, NSHAP enables researchers to address key questions on health and aging. We begin with recent findings on intimate dyads, then move to social participation, and finally to elder mistreatment. Among dyads, we find that whereas sexual activity drops sharply with age for both women and men, gender differences in partner loss as well as psychosocial and normative pressures constrain women’s sex more than men’s. However, surviving partnerships tend to be emotionally and physically satisfying and are marked by relatively frequent sex. In contrast to sex, nonsexual intimacy is highly prevalent at older ages, especially among women. Older adults are also socially resilient—adapting to the loss of social ties by increasing involvement with community and kin networks. Despite these social assets, older adults remain vulnerable to mistreatment. Overall, these findings yield a mixed picture of gender-differentiated vulnerabilities balanced by proactive adaptation and maintenance of social and dyadic assets.     

Exposure Assessment Approaches for Engineered Nanomaterials

Products based on nanotechnology are rapidly emerging in the marketplace, sometimes with little notice to consumers of their nanotechnology pedigree. This wide variety of nanotechnology products will result (in some cases) in unintentional human exposure to purposely engineered nanoscale materials via the dermal, inhalation, ingestion, and ocular pathways. Occupational, consumer, and environmental exposure to the nanomaterials should be characterized during the entire product lifecycle—manufacture, use, and disposal. Monitoring the fate and transport of engineered nanomaterials is complicated by the lack of detection techniques and the lack of a defined set of standardized metrics to be consistently measured. New exposure metrics may be required for engineered nanomaterials, but progress is possible by building on existing tools. An exposure metric matrix could organize existing data by relating likely exposure pathways (dermal, inhalation, ocular, ingestion) with existing measurements of important characteristics of nanoscale materials (particle number, mass, size distribution, charge). Nanomaterial characteristics not commonly measured, but shown to initiate a biological response during toxicity testing, signal a need for further research, such as the pressing need to develop monitoring devices capable of measuring those aspects of engineered nanomaterials that result in biological responses in humans. Modeling the behavior of nanoparticles may require new types of exposure models that individually track particles through the environment while keeping track of the particle shape, surface area, and other surface characteristics as the nanoparticles are transformed or become reactive. Lifecycle analysis could also be used to develop conceptual models of exposure from engineered nanomaterials.     

“Just Like I'm Saving Money in the Bank”: Client Perspectives on Care Coordination Services

Older adults face many challenges to community living. The literature has not sufficiently explored the roles of care coordination in the maintenance of housing and access to health care among older adults, particularly from their own perspectives. This qualitative study analyzes the findings from 25 interviews and 6 focus group discussions (48 participants) with a multiethnic sample of older adults in the New York City area. Care coordination services appear to assist older adults access health care, and to a lesser extent, maintain affordable housing. Disparities in access to care coordination appear to remain for immigrant, minority and suburban populations.     

Measuring the Effectiveness of Experiential Date Nights: A Qualitative Study

ABSTRACT

This qualitative study examines the experience of 13 couples who attended a relationship education date night in two metropolitan areas in a western state. The intent of these date nights was to reach audiences that may not attend traditional classroom relationship education. Reasons for, benefits of attending, and impacts were explored with participants. Findings indicate that most participants had fun and enjoyed spending time together, learned qualities and skills of healthy relationships, and had positive learning experiences with other couples. Additionally, although most individuals’ reason for attending was to have fun, most experienced a positive impact on their relationships after the event, such as improved communication, increase in affection and gratitude, or spending more time together. This finding may indicate that regardless of the reasons for attending, it is possible to create an environment for learning relationship skills that can, and most likely will, extend beyond the night of the event and could potentially lead to long-term positive impacts in relationships. Based on findings and existing research, activity-based relationship education, such as date nights, needs to be taken seriously as a model for couple education and considered as part of a well-rounded approach to relationship education.     

24-month update on the impact of roundtables on permanency for youth in foster care

Although the number of children in foster care has decreased in recent years (U.S. DHHS, 2012), additional strategies are needed to help youth achieve legal permanency before they age out of foster care. One such strategy is the permanency roundtable, which convenes a team of professionals to facilitate the permanency planning process by identifying realistic solutions to permanency obstacles for youth. Nearly 500 youth went through the initial permanency roundtable process in Georgia in 2009. Just over half were male (57%) and over nine in ten (92%) were African American. At the start of the roundtables, the median age was 13, and the median length of stay in foster care was 52 months. Two years after their roundtable, 50% of the nearly 500 children had achieved legal permanency. Analyses, presented separately for three age groups (0–6, 7–12, and 13–18), examine outcomes and predictors of legal permanency. Recommendations, limitations, and areas for future research are discussed.     

Using Adjuncts in Social Work Education: Challenges and Rewards

Adjunct faculty have become an essential addition to social work programs in the United States. Full-time social work faculty have not been able to meet the demands created by continued growth of BSW and MSW programs. The number of doctoral students in social work programs has not kept up with the growth of the programs. A survey of program directors available through the Association of Baccalaureate Social Work Program Director's (BPD) listserv in the United States found that respondents saw adjunct faculty as assets to social work programs. The survey results indicated that adjunct faculty provide a ‘value added’ component. Adjuncts need to receive an orientation and continual training to help prepare them for classroom management and become aware of university policies. Adjuncts can be retained if they receive training, have frequent contact with faculty, and have access to university resources.     

Co-training: Developing a model for practice

This article is an account of two workers' efforts to understand how and why co-training works. Advantages of co-work in the sphere of training are outlined, three models of co-training are described, and the methodology of the model used in practice is discussed. The workers are keen to promote co-training as a method of work which benefits both trainers and course participants. The article is based on their own experience and the authors would not want it to be viewed as a finished product but rather as the stage they have reached in understanding and developing a particular model of co-training. It is hoped that readers will be prompted to value and to share their own experiences of co-training.     

Effects of sociodemographic factors,stage of illness,and perceived stigma on the identification of a support person among women with HIV infection

Addressing the lack of research on the social distribution of social support and research on the social experience of women with HIV infection, this article examines how sociodemographic factors, stage of illness, and perceived stigma affected the identification of a supportive social relationship among HIV‐infected women. Data were collected from women with HIV disease living in the state of Georgia. Logistic regression analysis indicates that after taking account of other factors, marital status, rural‐urban residency, stage of illness, and stigmatization were significant predictors of whether the women identified a support person. Single status and rural residency had negative effects on the outcome. Those who were at the advanced stage of illness were less likely than those at the asymptomatic stage to identify a supportive relationship. Contrary to our expectation, stigmatization had positive effects on the outcome. Implications and limitations of the analysis are discussed, followed by directions for future research.     

An Exploration of Adjustment Needs and Efforts of Persons with Dementia After Relocation to a Residential Care Facility

This study examined the adjustment needs and efforts of individuals with dementia after relocation to a residential care facility. This was a qualitative prospective study that involved in-depth face-to-face interviews with 16 individuals with dementia and their family caregivers at 2 and 6 months post-relocation. In their efforts to recreate a sense of home, individuals with dementia had to meet three major highly interrelated and overlapping categories of needs to settle in, fit in, and find meaning in this transition. The satisfactory fulfillment of these adjustment needs resulted in a sense of comfort, connection, and continuity associated with feeling at home. Participants’ efforts to place themselves in their new living environments created a simultaneous need to integrate relocation into their overall sense of self. The results support earlier research indicating that place making is a critical process in the overall psychosocial adjustment to old age. The findings inform supportive interventions to assist individuals with dementia to reconstruct home in a residential care environment.     

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.