Gaps in social protection for health care and long‐term care in Europe: Are the elderly faced with financial ruin?

While public expenditure on health care and long‐term care (LTC) has been monitored for many years in European countries, far less attention has been paid to the financial consequences for older people of private out‐of‐pocket (OOP) expenditure necessary to access such care. Employing representative cross‐sectional data on the elderly populations of 11 European countries in 2004 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we find that OOP payments for health care and LTC are very common among the elderly across European countries and such expenditures impact significantly on disposable income: up to 95 per cent of the elderly make OOP payments for health care and 5 per cent for LTC, resulting in income reductions of between 5 and 10 per cent, respectively. Failure to prevent financial ruin, as a consequence of excessive OOP payments, is evident in 0.7 per cent of elderly households utilizing health care and 0.5 per cent of elderly households utilizing LTC. Those particularly concerned are the poor, women and the very old.     

Older Adults’ Expectations about Mortality,Driving Life and Years Left without Driving

ABSTRACT

People are living and driving longer than ever before, with little preparation for transitioning to being non-drivers. We investigated driving expectations among drivers age 65 and older, including sociodemographic and driving context predictors. Cross-sectional data from 349 older drivers were explored to determine variation in how many years they expected to continue driving. General linear models examined predictors of both expectations. In this predominantly Black/African American sample, 76% of older drivers (mean age = 73 ± 5.7 years) expected a non-driving future, forecasting living an average of 5.75 ± 7.29 years after driving cessation. Regression models on years left of driving life and years left to live post-driving cessation predicted nearly half of the variance in older drivers’ expectations with five significant predictors: income, current age, age expected to live to, self-limiting driving to nearby places and difficulty, visualizing being a non-driver. Many older drivers expect to stop driving before end of life.     

Attachment network structure as a predictor of romantic attachment formation and insecurity

We present a new framework to conceptualize normative variation in attachment network structure and use the framework to predict romantic attachment formation and attachment insecurity. Young adults (N = 2,055) completed the Attachment Network Questionnaire and were classified into one of four network types based on two comparisons: (a) between their primary and secondary figure, and (b) between their secondary and tertiary figure. Each comparison was coded as Similar (S) or Different (D), resulting in the following distribution across four network types: (a) 40% D:D—diversified; (b) 32% D:S—monotropic; (c) 19% S:D—joint principal; and (d) 9% S:S—distributed. Romantic duration predicted a developmental sequence of network structure consistent with infant attachment formation. Findings also indicated that the nonhierarchical network, distributed type, was associated with insecure attachment representations. Results suggest that attachment networks exhibit greater structural diversity than is commonly assumed and that the new framework is useful for understanding developmental and social outcomes.     

‘Growing Old’ in Shelters and ‘On the Street’: Experiences of Older Homeless People

Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (n = 14) and persons new to homelessness in later life (n = 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.     

Health Technology Literacy: A Transdisciplinary Framework for Consumer-Oriented Practice

Abstract

The present study developed a typology of self-reported coping strategies used by older adults in adapting to vision impairment using qualitative analyses. Narrative data were examined from three previous quantitative studies of adaptation to vision loss. Major themes in coping with vision loss included difficulty in balancing norms of independence with the functional losses resulting from eye disease, and the importance of the informal social network. Importantly, a number of coping mechanisms that have not been examined in prior quantitative work were identified through the present qualitative analyses. Implications of this typology of self-reported coping with age-related vision loss for research and practice are discussed.     

Senior Gambling: Risk or Reward?

For a growing number of older adults, a day outing to a local casino has become one of the more enjoyable and accessible opportunities for socialization and entertainment. Unfortunately, for some older adults this growing pastime increases their risk for developing a gambling problem or, worse yet, a gambling addiction. The consequences of problematic gambling behaviors for individuals living on a fixed income require greater attention by social work researchers, practitioners, and providers of senior services. The development and implementation of a Gambling Education Workshop for older adults attending senior centers in a large metropolitan area, along with qualitative interviews with a sample of workshop participants, are reported in this article. Among the findings from this project are the needs for greater awareness of the risk factors associated with problematic gambling, as well as greater awareness among older adults about the consequences associated with gambling.     

Reaching Isolated Older People

In the second part of a paper reporting a unique single day a week adult day program, the service methodologies developed in the program are described as well as a study of outcomes in four areas: success in reaching the target group, attendance, length of participation, and resolution of psychosocial and health related problems. Outcomes, illustrated by statistical and case material, indicate success in achieving the overall goal of maintenance and enhancement of the participant's life and functioning as a whole. Such a resource is recommended as a vital one for the target population of isolated older people described in the paper.     

A Pilot Study About the Needs of Older Gays and Lesbians

Abstract

In a pilot study, a population of gay and lesbian elders were surveyed to determine what types of long term plans they have made in preparation for their old age, what types of information they feel service providers need to know to better meet their long-term needs, and what is their perception of aging. The results of this pilot study demonstrated that almost three-fourths of the total sample have started to make plans for growing old. The respondents reported that social workers needed to be more knowledgeable about gay lifestyles and the importance of their partners. It was also found that the views of aging became more positive as the gay and lesbian individuals grow older.     

Environmental and Behavioral Circumstances and Consequences of Falls in a Senior Living Development

This article investigated the role of environmental and behavioral factors surrounding fall incidents in a senior living community. Using a mixed-methods approach, this research included both a retrospective analysis of fall reports and resident interviews. The quantitative analysis showed falls in the bedroom and bathroom were more likely to happen between 12 am and 8 am. Falls in the bathroom were more likely to result in severe injuries compared to falls in other rooms. The qualitative analysis identified three types of fall-related activity (transfer, ambulation, standing) and five behavioral factors surrounding fall incidents (transferring, slipping, misjudged behavior, tripping, health issue).