Older Drivers Retiring From the Road: An Application of the Selection,Optimization, and Compensation Model

Purpose: This study uses the selection, optimization, and compensation (SOC) model to compare older adults who have given up driving, those who still drive, and those who drive less to identify differences in the three groups. Design and Methods: This cross-sectional study of 281 older adults is part of the Naturally Occurring Retirement Community Demonstration Project. Study participants completed interviews that included questions on demographics, health and functioning, mental health, social support, and current levels of engagement in activities including current driving status. Results: Data suggest that driving retirement is a process and that a substantial number of people are in the transitional stage, where they are less functional than those who still drive and more similar to those who have retired from the road. Implications: Given the similarity of those who drive less to those who have given up driving, front-line professionals and policy makers must work together to ease the transition to driving retirement for those without adequate ability to effectively compensate for their inability to continue to drive safely.     

Voices of Resilience

Abstract

Terminally ill older adults have the capacity to live well in the context of dying. Having negotiated a lifetime of challenges, they have resources to demonstrate resilience and achieve wholeness in life's final phase, but research has not adequately investigated this process. This qualitative research study considered the paths to resilience used by 30 older adult hospice clients in Kansas and Illinois. Responses were coded using the grounded theory method of Strauss and Corbin (1990) where data drives interpretation and text is coded into categories. Results centered on four themes that included: (1) a redefinition of self; (2) use of religion/spirituality or openness to uncertainty; (3) maintenance of social investments; and (4) guarding independence even as the scope of life contracted. Results imply that attention should be paid to building environments of wellness. This may be accomplished paradoxically through facilitating continuity of client interests and yet opportunities for creativity and growth as well. Listening with a healing stance and cultivating a habit of being fully present in interactions with clients assist in this process.     

Professional stances and personal values in the realm of transnational family reunification with older parents: social work practice in an emerging field

National rules for family reunification take place in an increasingly transnational context. Social workers in Switzerland, whether they work in services for migrants or for elders, are confronted with requests for transnational family reunification with older parents. Such requests, while relatively rare, elicit responses which must be viewed as largely founded on professionals' values and norms regarding the care of elders, family cohabitation, the influence of cultural factors, and examined against a backdrop of increasing suspicion of motives for migration—especially in fields where migration issues have not been at the forefront of professional debate and practice. The militant stance of some services for migrants can thus be contrasted with the relative inexperience of professionals active in social services for elders, who rarely encounter recent migrants. The latter are more likely to reflect their own private—and unexamined—views when advising clients in a field characterised by complexity and instability. The authors interviewed social workers and families in two Swiss cantons. Their results point to ways in which distinct professional cultures could enrich each other and provide social workers with tools to critically analyse their own practice in a very difficult field, the contours of which remain largely unexplored.     

Global Patterns of Healthy Life Expectancy for Older Women

SUMMARY

This paper focuses on patterns of healthy life expectancy for older women around the globe in the year 2000, and on the determinants of differences in disease and injury for older ages. Our study uses data from the World Health Organization for women and men in 191 countries. These data include a summary measure of population health, healthy life expectancy (HALE), which measures the number of years of life expected to be lived in good health, and a complementary measure of the loss of health (disability-adjusted life years or DALYs) due to a comprehensive set of disease and injury causes. We examine two topics in detail: (1) cross-national patterns of female-male differences in healthy life expectancy at age 60; and (2) identification of the major injury and disability causes of disability in women at older ages. Globally, the male-female gap is lower for HALE than for total life expectancy. The sex gap is highest for Russia (10.0 years) and lowest in North Africa and the Middle East, where males and females have similar levels of healthy life expectancy, and in some cases, females have lower levels of healthy life expectancy. We discuss the implications of the findings for international health policy.     

The Right to Take Risks: Alcohol and Older People

This paper examines policy and practice regarding the purchase of alcohol for older clients of home carers in three local authorities in the Greater London area. Data were gathered from interviews with home carers and their managers, focus group discussions, and a postal survey. None of the local authorities had a written policy or written guidance on alcohol purchase or on appropriate responses to the identification of problematic drinking in older clients. The findings illustrate the problem of balancing "rights" and "risks" within a philosophy of community care which emphasizes client choice and autonomy, and show how policy and practice are "tailored" by local contexts. It is suggested that both home carers and other domiciliary workers, as well as their older clients, could benefit from a clear code of practice regarding responses to alcohol consumption and problematic drinking by older people.     

美国老年人长期照护法律体系及其对我国的启示

以1965年美国老年人法案(the Old Americans Act)及之后的一系列修正案和相关法律法规为主要素材,着重从政府角度介绍美国老年人长期照护法律体系的建立过程以及在此过程中政府职能的相应转变。本文介绍了老年人长期照护的含义,归纳了美国老年人长期照护法律体系建立的意义,指明了老年人长期照护法律关系中政府的特殊地位,并结合中国目前老年人长期照护的现状对我国老年人法律体系的完善提出了一些启示。     

Old and Cold: Older People and Policies Failing to Address Fuel Poverty

Research, funded by the British Gas Help the Aged Partnership and carried out by the Institute of Gerontology, King's College London, explored the multidimensional issues of fuel poverty. A sample of older homeowners and private renters living in England, Scotland and Wales were interviewed in the Spring of 2003 to explore their experiences of keeping their homes warm in the preceding winter. It was found that almost half of the sample for whom full information was available were in fuel poverty. Government schemes failed to address some important issues. Grants were only available to those with “passport benefits”, excluding those who had minimal occupational pensions. Although most respondents had central heating, it was often old and ineffective, yet grants were not available to modernize them. Government schemes did not extend to paying for external and internal insulation for solid wall properties yet many older people live in such property. Several older people lived in rural areas not connected to mains gas. As mains gas currently provides the cheapest fuel, they faced high bills, yet government policies do not address the differential fuel costs in these areas. The culture of many older people in the study contributed to their living in cold homes. They lived frugally and usually turned heating off in daylight hours during winter. It was also a common practice to sleep in an unheated bedroom during winter and to keep the window open at night. Such practices are acknowledged to be unhealthy.     

Personal Reflections on Closeted Helping Professionals

Abstract

The author discusses the situation of closeted professionals whose “private” lives inadvertently cross paths with homosexual students or clients. Personal vignettes highlight the dangers of encounters with “closeted” professionals for homosexual clients and students. Particular attention is given to the long-term impact upon clients and students, who are viewed as more vulnerable than professionals. Reflections upon sociopolitical implications of the “closet” are noted, especially recent retrenchment of media concern for homosexual issues as professionals have retreated to the “closet.”     

Social work in the development of institutional care for older people in Slovenia

Social work in homes for older people in Slovenia has a special role since we have extremely institutionally-oriented care for older people. Characteristic of the development of Slovenian homes for older people is a shift in the dynamics of the orientation of the homes from a medical to a social one. Different factors influenced the shift towards a social orientation, i.e. the policy of establishing homes, the influence of sociogerontological principles, the development of social work and, recently, by their engagement with residents with dementia. In socially-oriented homes a different model of social work is used than in medically-oriented ones. The difference lies in social work methods as well as in the roles of the social worker in different areas of work with the residents, relatives and staff. By defining a model of social work in a socially-oriented home, a special field of social work with older people in the field of institutional care in Slovenia has been developed.     

Transitional Youth Services: Practice Implications from a Systematic Review

Independent living programs have emerged as the primary intervention to address the needs of foster youth transitioning out of care. Prior reviews of independent living programs have focused on implications for research and policy, but not on direct practice. In order to create effective independent living programs, direct service workers must be provided with concrete practice guidelines for providing effective independent living services. This article summarizes 19 studies on independent living and provides evidence-based implications for each in an effort to begin to fill the gap between research, policy and practice.