An International Review of the Long-Term Care Workforce

Abstract

The developed world's population is aging, due to trends of increased life expectancies and decreased fertility rates. These trends are predicted to increase demand on long-term care services. At the same time, the long-term care workforce is in shortage in most of the developed world. Moreover, such shortages are expected to increase due to parallel socio-demographic factors. The increase in demand for long-term care, coupled with shortage in supply of care workers, has promoted some attention from policymakers. The current paper provides an international review of institutional arrangements for long-term care in different developed countries and in particular explores different strategies used or proposed to resolve the shortage in the long-term care workforce.     

The Last Stitch in the Quilt

The patterns of our working lives are fluid and often unpredictable. They are linked to the process of identity forming that we understand as a recognizable, but continuously changing pattern of actions and developments within our lifespan, which includes our career choices. This interpretation allows us to identify the multiple temporal trajectories within a working life and to see how an analysis of temporalities can help us to understand the gendered nature of our careers. By using a number of retrospective narratives of older women about their working lives, we ascertain how an externally imposed and chronologically organized linear (life‐) career story breaks down into a number of a‐chronological trajectories, each of which is personally marked by the identity of the narrator. The theme of self‐care emerges and turns into a binding notion for working women from different generations.     

Is the association between social capital and health robust across Nordic regions? Evidence from a cross‐sectional study of older adults

Nyqvist F, Nygård M. Is the association between social capital and health robust across Nordic regions? Evidence from a cross‐sectional study of older adults The study examined the association between structural and cognitive social capital and self‐rated health among 65‐ and 75‐year‐olds in Västerbotten in Sweden and Österbotten and Pohjanmaa in Finland. Data were retrieved from a cross‐sectional postal questionnaire survey conducted in 2005 and was answered by 3,370 persons, yielding a total response rate of 69 per cent. The association between self‐rated health and interpersonal trust and membership in organisations was tested by logistic regression analysis. The results showed that older adults in Västerbotten in Sweden experienced better self‐rated health than in Finland. Furthermore, interpersonal trust and active membership in organisations were associated with self‐rated health among 65‐ and 75‐year olds even after having controlled for the influence of region. We therefore conclude that the association between social capital and self‐rated health tends to be robust across contextually similar regions, but that further analyses are warranted in order to clarify the nature of this relationship. Key Practitioner Message: ?Health status can be indirectly strengthened through investments in social capital, such as group participation and active networks; ?When working with older adults, more focus needs to be put on how to develop trustful relationships; ?The Nordic welfare state, with its universal and subsidised social and health care services, has an indirect and positive effect on health among older adults.     

An Exploratory Study of Older Adults' Engagement with Virtual Volunteerism

Virtual volunteering refers to the use of the Internet for volunteer services. It is an emerging phenomenon among every age group; however, the current study examines if it is a viable option for older people. Older adults are the fastest growing Internet users. They are also more civic minded than younger generations, thus the purpose of this study is to explore this relatively new area research. Data for this study have been collected using qualitative tools such as semistructured, partly open-ended interviews with older virtual volunteers affiliated with SeniorNet, an organization that facilitates virtual volunteering exclusively for older people. The study ends with suggestions for future research directions. Implications of this study include reconceptualization of virtual volunteering as a strategic tool to recruit older adults and greater usage of information communication technologies to promote civic engagement among older people and, thus, positively influence their health and well-being.     

Evaluating Social Integration and Psychological Outcomes for Older Adults Enrolled at a University Intergenerational Program

Abstract

Intergenerational programs are proliferating. The basic assumption of such programs is that pairing older and younger people in various activities and contexts such as educational programs will produce positive developmental benefits for all participants. Educational programs appear to help adults to remain socially active and connected. The University of Valencia (Spain) initiated in 1999–2000 a “University Program for Seniors” for adults age 55 and over, entitled “Nau Gran.”The goal of this paper is to present baseline results on the benefits and impacts for older adults enrolled at the program during 2002. Results from a sample of 212 sophomore and junior older adult participants are presented. The questionnaire included socio-demographic information and items regarding health, social integration, and psychological outcomes. Results indicated that older adults attending courses at the University increased their level of social integration.     

Older Gay,Lesbian, and Bisexual Adults: Tools for Age-Competent and Gay Affirmative Practice

This article presents a demographic snapshot of older GLB adults, discusses the barriers to service provision, and melds aging competencies with that of affirmative practice with GLB individuals. Its goals are to delineate the specific knowledge, attitudes, and skills recommended for age-competent and gay affirmative practice with an aging GLB population.     

Psychotherapy with Lesbian,Gay, Bisexual,and Transgender Older Adults

A small literature has addressed psychotherapy with lesbian, gay, bisexual, and transgender (LGBT) samples over the past two decades. Older adults have also been investigated in a growing number of psychotherapy research studies. However, psychotherapy specifically with LGBT older adults has not received adequate investigation. This review relies on converging lines of research to provide an integrated discussion of evidence-based psychological treatments (EBTs) with current research and clinical observations in the field of gerontology and suggests ways in which these topics can inform psychotherapy practice with LGBT older adults. We summarize current research on aging in several areas of practical interest to psychotherapists seeking to apply EBTs in their work with LGBT older adults. These areas include: adult development, coping, stigmatization, social context, and the effects of cohort membership. The results of these studies belie stereotypes regarding both the aging process, in general, and more specifically LGBT older adulthood, with significant implications for the practice of psychotherapy. EBTs are adaptable to a variety of issues encountered in later life by LGBT older adults, and these modifications to therapeutic technique are addressed throughout.     

Midlife and Older Gay Men Living with HIV/AIDS: The Influence of Resiliency and Psychosocial Stress Factors on Health Needs

HIV/AIDS research has mostly focused on younger gay men. This cross-sectional study originated from a larger study of 316 respondents to include a subsample of 38 midlife and older gay men living with HIV/AIDS. The study explores physical and mental health utilization rates, including physical and mental health status. Resiliency, internal health locus of control beliefs, and psychosocial stressors of age and sexual orientation discrimination, stigma, and internalized homophobia were also examined. A total of 65.8% of the HIV/AIDS participants received no mental health services the past year, despite reporting higher mental health distress. Of those reporting an HIV status, 10.5% indicated having no health visits in the preceding year and more delays in seeking care when needed and unmet health needs for which services were not sought. Participants reporting higher resiliency indicated less mental health distress and better health access indicators. Stigma and internalized homophobia negatively affected resiliency. Implications for practitioners working with midlife and older gay men are provided.     

Honoring,Training, and Building a Statewide Network of Elder Activists: The California Senior Leaders Program (2002–2012)

This case study explores the first decade (2002–2012) of the California Senior Leaders Program (CSLP), including participants' creation of a formal advocacy group, the California Senior Leaders Alliance. Grounded in concerns with ageism and invisibility, the CSLP provides recognition and support for diverse California elders engaged in community building and social justice work. This study employs qualitative analysis of data from participant interviews, event evaluations, program documents, video footage, and participant observation. Findings show emotional, learning, and networking benefits for participants, intergenerational influences, collective capacity and coalition building, and contributions to policy. Program challenges are described, and future directions discussed.     

Korean immigrant older adults residing in Non-Korean ethnic enclaves: Acculturation strategies and psychosocial adaptation

ABSTRACT

Based on Berry’s bi-dimensional model of acculturation, this study examined acculturation strategies among first-generation Korean immigrant older adults residing in areas without a well-established Korean ethnic enclave and how their acculturation strategies are associated with psychosocial adaptation and acculturative stressors. Cluster analysis (N = 108) identified three acculturation strategies such as separated, moderately bicultural, and fully bicultural, indicating that the sample did not exhibit all four acculturation strategies of Berry’s model. The moderately bicultural group of the sample was the most dominant in size, which indicated strong adherence to Korean culture. The fully bicultural group reported less acculturative stress and depressive symptoms than the separated group, which indicated that biculturalism is strongly associated with a better psychosocial adaptation. A factor analysis showed that the separated group perceived stressors such as limited English proficiency and social isolation as more stressful than the other groups. The findings suggest that even though a strong adherence to ethnic culture might be a first-generation Korean immigrant older adults’ dominant acculturation strategy, it may make them more vulnerable to lingual and cultural barriers in a mono-cultural community without Korean ethnic enclaves. Implications for social work practice are explored.