Compulsory intergenerational family solidarity shaping choices between work and care: Perceptions of informal female carers and local policymakers in Estonia

Estonians are obliged by law to provide maintenance for family members who are unable to cope by themselves. As a result, 80% of fragile older people receive informal care. Whether this is because the carers themselves feel solidarity and choose informal caring or because they lack alternatives is the question. We applied the cultural approach for explaining the construction of compulsory family solidarity in care provision to older people through the perceptions of informal carers and policy actors. Our interest is in how filial norms framed by individual responsibilities of care provision required by law can influence (i) informal carers’ perceptions concerning their choices between work and care and (ii) impact policy actors’ perceptions concerning eldercare service provision. Analysing the empirical data produced during focus groups with female carers and interviews with policy actors, we demonstrate the triple‐fold pressure to informal caregiving as an expression of compulsory family solidarity. Key Practitioner Message: ? The article demonstrates how the national Family Law Act constitutes a compulsory requirement of family solidarity in society; ? The compulsory family solidarity norm influences local‐level policymaking and inhibits the development of formal care services for older people; ? Informal carers’ choices between work and care are shaped by their personal filial norms, familialistic policymaking, and pressure exerted by older people.     

Psychosocial risk factors and processes impeding adaptive capacities and contributing to psychosocial distress among later-life Egyptian immigrants

ABSTRACT

This qualitative study explores and describes the transactional and cumulative psychosocial stressors that later-life Egyptian immigrants encounter upon coming to the United States, and how they impede their adaptive capacities, hinder their adjustment efforts, and impact their psychosocial well-being. Such stressors are more pronounced among those who immigrated to the United States from Egypt after reaching the retirement age of 60 for two reasons. First, they experience pre-immigration stressors that force or expedite their departure from Egypt under duress, thus incurring numerous financial and symbolic losses. Secondly, in the last developmental stage, when age-related losses are triggered, they are concomitantly exposed to a starkly different lifestyle, language, cultural norms, living and financial arrangements, roles, and relationships. All such circumstances contribute to a sense of confusion, guilt, shame, and being a burden on others, which culminate in withdrawal, isolation, and distress. The findings of this study can be used to inform psychosocial and therapeutic interventions and guide the development of appropriate social work programs, services, and policies for later-life Egyptian immigrants in particular and older Arabic-speaking immigrants in general.     

Disaster preparedness networks in rural Midwest communities: Organizational roles,collaborations, and support for older residents

ABSTRACT

This study investigated the roles and interconnections among community organizations belonging to local disaster coalitions in Midwest in supporting older residents. Representatives from 44 organizations participated in one-time survey. Most were non-profit (68%) or federal/state/local government agencies (23%). The analyses of 761 relationships showed stronger collaborations in assessment (average strength=2.88 on a 5-point scale), emergency response (2.72), and planning (2.61); and weaker collaborations in co-sponsoring programs (1.71) and supporting older residents (2.03). The extent of collaboration (network density) to support older adults was also low. Coalitions may enhance network density and centralization by developing sub-committee structure and strengthening existing collaborations.     

The Effect of Chair Yoga on Biopsychosocial Changes in English- and Spanish-Speaking Community-Dwelling Older Adults with Lower-Extremity Osteoarthritis

Chair yoga (CY), a mind-body therapy, is a safe nonpharmacological approach for managing osteoarthritis (OA) in older adults who cannot participate in standing exercise. However, there is no linguistically tailored CY program for those with limited English proficiency (LEP). This 2-arm randomized controlled trial compared the effects of a linguistically tailored yoga program (English and Spanish versions) on the outcomes of pain, physical function, and psychosocial factors compared to the effects of a linguistically tailored Health Education Program (HEP; English and Spanish versions). Participants with lower-extremity OA, recruited from 2 community sites, completed the Spanish (n = 40) or English (n = 60) version of twice-weekly 45-min CY or HEP sessions for 8 weeks. Data were collected at baseline, 4 weeks, 8 weeks, and 1- and 3-month follow-ups. English and Spanish CY groups (but neither HEP language group) showed significant decreases in pain interference. Measures of OA symptoms, balance, depression, and social activities were not significantly different between English and Spanish versions of CY and English and Spanish versions of HEP. It was concluded that the Spanish and English versions of CY and HEP were equivalent. Linguistically tailored CY could be implemented in aging-serving communities for persons with LEP.     

Family Caregiving and the Site of Care: Four Narratives About End-of-Life Care for Individuals with Dementia

Little is known about end-of-life care for individuals with Alzheimer’s disease and other dementias. Four case studies are presented, using data collected by qualitative interviews conducted with family caregivers who were closely involved with end-of-life care for relatives with dementia. The case studies are formatted in two pairs, with one reflecting two deaths occurring at home and the other pair representing two deaths in the nursing home. The cases reveal a range of end-of-life experiences, suggesting that there is not just one “good” path. The extent of care needed, the responsiveness of the individual, the health of the caregiver(s), and the residence and support situations, can all intersect in a variety of ways that make no one scenario the answer for all. Although most people say they would prefer to die at home, in some situations the nursing home can be a satisfactory choice, particularly if hospice is involved. These narrative case studies give the reader insight into the variety of the end-of-life experiences and suggest the environment should be considered as part of the care provision.     

Evaluation of Verbal Behavior in Older Adults

Approximately 5% of older adults have a dementia diagnosis, and language deterioration is commonly associated with this disorder (Kempler, 2005). Several instruments have been developed to diagnose dementia and assess language capabilities of elderly adults. However, none of these instruments take a functional approach to language assessment as described by Skinner (1957). The purpose of this study was to develop and evaluate a function-based assessment for language deficits of older adults. Thirty-one participants were categorized into a control group (n  =  15) and a dementia group (n  =  16) based on their score on the Dementia Rating Scale-2. Individuals with dementia performed significantly worse on the tact assessment than those without dementia. Participants from both groups performed better on measures of tacts than intraverbals or mands, even though topographically identical responses were required in these assessments. The data provide support for Skinner''s conceptualization of functionally independent verbal operants.     

“Do They Think I Am a Pack Rat?”

This case study presents details of the life of one older man who lived in seclusion and squalor, surrounded by hoarded possessions. This man was one participant of a focused ethnography of eight older adults who received home care. All participants in the original ethnography were identified by their community care coordinators as exhibiting hoarding behaviors. The case study presented here provides rich narrative and photographic detail in order to add strength to what has already been presented in previous research articles about compulsive acquisition. The narratives reveal examples of debilitating dysfunction, distress associated with decision making, broad acquisition of free things, compulsive buying, and ritualistic discarding. Quotes included in the case study stem from the original ethnography.     

Older People's “Voices”—On Paper: Obstacles to Influence in Welfare States—A Case Study of Sweden

The official rhetoric of welfare states unconditionally pays tribute to older people's right to express dissatisfaction. In practice, users of older services in welfare states may be deprived of their “exit” options and face considerable constraints when it comes to raising their “voices.” For example, when older people in nursing homes would like to lodge a complaint, they may well be referred to the very staff members they depend on in their everyday lives. This article analyzes a national case study in which these contradictory tendencies are especially explicit: formal influence channels for older people in Sweden. Using data from structured interviews with 100 representatives of Swedish municipalities and drawing on Hirschman's (1970) Hirschman, A. 1970. Exit, voice, and loyalty: Responses to decline in firms, organisations, and states, Cambridge, MA: Harvard University Press.  [Google Scholar] theory on exit and voice, the article analyzes obstacles to older service users' influence in Sweden and develops explanations for these obstacles in terms of social contexts.     

Negative Stereotyping of Older Nurses Despite Contact and Mere Exposure: The Case of Nursing Recruiters in Western Australia

Ageist attitudes have been identified across different industries. The nursing profession has a high proportion of older workers. As this facilitates regular contact with, as well as exposure to, older nurses, it may be expected to show less ageism. This study investigated 163 Western Australian nursing recruiters' attitudes toward older nurses. Results showed clear evidence of both negative and positive stereotyping of older nurses. Nursing recruiters indicated that they would be more than likely to hire older nurses and that age was less relevant in making hiring decisions. These findings suggest that enhancing the employability of older workers does not necessarily change ageist attitudes. This is relevant to policy formulation, attitude change interventions, and the well-being of older workers.     

Supplemental Security Income Among Older Immigrants From Central and South America: The Impact of Welfare Reform

This article explores the impact of federal welfare policy changes on older immigrants born in Central and South America. Using data from the 1990 and 2000 U.S. Census 5% Public-Use Microdata Samples, the study examines (1) the change in Supplemental Security Income (SSI) uptake rate after welfare reform for noncitizens from Latin America, naturalized Latin Americans, and U.S.-born Hispanics and (2) how much of the change can be attributed to a change in behavior rather than to a change in eligibility rates. Findings show that the decline in SSI receipt after welfare reform was greater for Latin American noncitizens compared to naturalized citizens and Hispanic U.S.-born citizens. Decomposition analyses show that among eligible elderly noncitizens, the decline in recipiency rate was due mostly to a change in behavior rather than a change in eligibility. This pattern is not found for U.S.-born and naturalized citizens, where changes were mostly due to a decline in the proportion of persons eligible for SSI. This suggests that as a result of legislative changes, older immigrants may not be applying for benefits for which they may be legally entitled. Policy implications are discussed.