Showing papers in "Journal of Gerontological Social Work in 2011"
TL;DR: There are very few services specific to the needs of older LGBT adults and very little outreach to this community, and at the agency level, resistance to providing services was found.
Abstract: Very little research exists examining the interactions between community-based aging service providers and lesbian, gay, bisexual, and transgender (LGBT) older adults. It is unclear whether mainstream aging services acknowledge the needs of this community. We asked direct care providers and administrators in the Michigan aging services network to describe their work with LGBT older adults. We found there are very few services specific to the needs of older LGBT adults and very little outreach to this community. At the agency level, resistance to providing services was found.
127 citations
TL;DR: This article examines one model that communities are using to help older adults age-in-place, the Village, and presents challenges to social work roles in facilitation and evaluation of the model.
Abstract: The US population of older adults will increase significantly in the coming decades. Most of these individuals prefer to age in their homes/communities. However, most communities are not prepared to handle the long-term care needs of an aging population. This article examines one model that communities are using to help older adults age-in-place, the Village. A conceptual lens based in community practice and empowerment theory is offered to explicate this model and critically evaluate social work's role in it. It also presents challenges to social work roles in facilitation and evaluation of the model.
68 citations
TL;DR: This study assessed impact of Alzheimer's patients' aggressive behavior on caregiver coping strategies (task-, emotion-, and avoidance-focused) and caregiver resilience, and examined whether coping strategy moderated the AD aggression–caregiver resilience relationship.
Abstract: This study assessed impact of Alzheimer's patients' aggressive behavior (AD aggression) on caregiver coping strategies (task-, emotion-, and avoidance-focused) and caregiver resilience, and examined whether coping strategy moderated the AD aggression-caregiver resilience relationship. Informal caregivers across Louisiana (N = 419) completed surveys with measures of demographics, AD aggression, caregiver coping strategies, and caregiver resilience. Task-focused coping positively related to resilience. Aggression negatively predicted caregiver resilience. Emotion- and avoidance-focused coping strategies separately interacted with aggression and increased its negative relationship to caregiver resilience. Task-focused coping showed no moderation. Implications for social work professionals are discussed.
63 citations
TL;DR: It is suggested that, with the onset of progressive cognitive impairment, verbal, nonverbal, and embodied exchanges can function as meaning-making processes for life-partner co-carers by combining a relationship- and strengths-based approach.
Abstract: By combining a relationship- and strengths-based approach, the article suggests that, with the onset of progressive cognitive impairment, verbal, nonverbal, and embodied exchanges can function as meaning-making processes for life-partner co-carers. These exchanges can sustain a sense of relatedness, which has been shown to increase wellbeing. The article identifies gaps in knowledge and practice limitations that result from the deficit approach to dementia research and care that currently dominates the field. Suggestions for future research and the development of interventions are included. In addition, the article challenges theoretical assumptions about meaning-making, arguing for a reexamination of dementia-affected couplehood processes.
63 citations
TL;DR: Practice perspectives on these transitions, based on a social work intervention for older adults discharged from an acute care setting to home, identify the role of surprises after discharge, an expanded view of the client system, and relationship building as instrumental in carrying out effective care transitions.
Abstract: Making the transition from hospital to home can be challenging for many older adults. This article presents practice perspectives on these transitions, based on a social work intervention for older adults discharged from an acute care setting to home. An analysis of interviews with clinical social workers who managed 356 cases (n = 3) and a review of their clinical notes (n = 581) were used to identify salient themes relevant to care transitions. Concepts developed and discussed identify the role of surprises after discharge, an expanded view of the client system, and relationship building as instrumental in carrying out effective care transitions.
46 citations
TL;DR: A survey addressing work/retirement, family, civic engagement, health, caregiving, leisure, and perceptions of senior services was mailed to 800 addresses randomly selected from a upper Midwestern county voter registration list.
Abstract: The future service needs of baby boomers are unclear A survey addressing work/retirement, family, civic engagement, health, caregiving, leisure, and perceptions of senior services was mailed to 800 addresses randomly selected from a upper Midwestern county voter registration list The response rate was 28% Fifty-three percent of the respondents (N = 225) intended to work and increase civic engagement They expected more time for hobbies and friends, and to travel more Family will continue to be their highest priority These findings will be useful to service providers who are invested in providing services that are attractive to boomers
45 citations
TL;DR: Qualitative analyses revealed that most participants equated personal mobility with driving a vehicle, and attitudes concerning mobility status and preparedness for change varied based on disability level and personal experience.
Abstract: The subjective responses associated with personal life space and mobility status were explored. Thirty individuals participated in focus groups based on self-rated disability status, current places visited, and availability. Qualitative analyses revealed that most participants equated personal mobility with driving a vehicle. Attitudes concerning mobility status and preparedness for change varied based on disability level and personal experience. Fear of dependence from future mobility loss was prominent in all groups. Few participants acknowledged significant planning for future retirement from driving or other mobility challenges. An understanding of common attitudes, perceptions and meanings can inform professionals who intervene and support older adults experiencing mobility changes.
44 citations
TL;DR: This study examined the perceptions of preparedness and support of informal caregivers of hospice oncology patients and identified multiple sources of support including hospice personnel, family, friends, neighbors, and spiritual beliefs.
Abstract: This study examined the perceptions of preparedness and support of informal caregivers of hospice oncology patients. Respondents included coresiding, proximate, and long-distance caregivers. Thematic analysis was used to analyze the qualitative data from 2 caregiver surveys, one administered prior to the care recipient's death and another completed 3 months postdeath. Respondents (N = 69) interpreted preparedness broadly and identified multiple sources of support including hospice personnel, family, friends, neighbors, and spiritual beliefs. Additionally, informational support, such as education, information, and enhanced communication were considered essential for preparing and supporting caregivers. Implications for social work research and practice are provided.
40 citations
TL;DR: The results showed that about 50% of participants reported a score of 16 and above on the CESD scale, indicating a presence of depressive symptoms, and most participants identified with their heritage culture compared to the American culture.
Abstract: Using a cross-sectional design, this study utilized a self-administered survey to examine the relationship between acculturation, physical and emotional health, health locus of control (LOC), life events and depression among a convenient sample of 70 immigrant Muslim elderly in United States of America. In addition to demographic variables, 5 standardized measures including the Vancouver Index of Acculturation, Center for Epidemiologic Studies Depression Scale (CESD), Iowa Self-Assessment Inventory, Multidimensional Health Locus of Control Scale, and the Geriatric Scale of Recent Life Events were utilized in this study. The results showed that about 50% of participants reported a score of 16 and above on the CESD scale, indicating a presence of depressive symptoms. In addition, most participants identified with their heritage culture compared to the American culture. The results of multiple regression analysis revealed 4 significant predictors of depression: cognitive status (β = −.34, p < .01), heritage ...
40 citations
TL;DR: This study used an adaptation of the caregivers' stress model to examine the positive aspects of caregiving with 113 Chinese American family caregivers who provided care to their elderly relatives and found that cultural values helped explain positive aspectsof caregiving.
Abstract: This study used an adaptation of the caregivers' stress model to examine the positive aspects of caregiving with 113 Chinese American family caregivers who provided care to their elderly relatives. The hierarchical multiple regression analysis indicated that combination of caregiver background characteristics, stressors, and cultural values had direct effects on positive aspects of caregiving. Unlike previous studies in which cultural values were not measured, this study found that cultural values helped explain positive aspects of caregiving. Specifically, cultural values, caregiver's health, and caregiver's age predicted positive aspects of caregiving. Service implications are discussed based upon the findings.
39 citations
TL;DR: The major biopsychosocial and family issues of aging with a psychiatric diagnosis are highlighted and intervention approaches that have demonstrated efficacy are summarized along with ways to coordinate services across multiple service delivery sectors.
Abstract: Severe mental illness (SMI) impacts many different facets of individuals' lives. As they age, those with SMI experience increased physical illnesses, functional impairment, cognitive deficits, and social disability. To promote more effective social work practice with this population, this article highlights the major biopsychosocial and family issues of aging with a psychiatric diagnosis. In addition, intervention approaches that have demonstrated efficacy are summarized along with ways to coordinate services across multiple service delivery sectors. Finally, future directions in practice and research are presented to develop additional methods of support for older adults with SMI and their families.
TL;DR: The empirical literature that investigated trauma and stress among older adults in the criminal justice system was reviewed and findings revealed past and current trauma and Stress, consequences and/or correlates, and internal and external coping resources among aging offenders.
Abstract: The purpose of this article was to review the empirical literature that investigated trauma and stress among older adults in the criminal justice system. Nineteen journal articles published between 1988 and 2010 were identified and extracted via research databases and included mixed age samples of adjudicated older and younger adults (n = 11) or older adult only samples (n = 8). Findings revealed past and current trauma and stress, consequences and/or correlates, and internal and external coping resources among aging offenders. The implications and future directions for gerontological social work, research, and policy with older adults in the criminal justice system are advanced.
TL;DR: The application of theory in qualitative research with 36 caregivers provides insight into why most delay service use, and improvements are required to service promotion, as well as to models of care.
Abstract: Understanding the beliefs that caregivers of people with dementia have in regard to the use of residential respite may inform strategies to address low service utilisation. In this article, the application of theory in qualitative research with 36 caregivers provides insight into why most delay service use. Although some believe that service use may increase caregiving longevity, others position service use in conflict with normative values, and may hold beliefs that negative outcomes will result from utilisation. To address caregivers' beliefs to support service use, improvements are required to service promotion, as well as to models of care.
TL;DR: A hypothetical case is introduced to illustrate the importance of identifying nursing home residents with past trauma experiences and the current assessment tools fail to account for reactions to early-life trauma.
Abstract: Reactions to early life trauma can reemerge or be exacerbated in later life as coping resources and abilities are compromised by age-related changes and declines in health. For newly admitted nursing home residents, this can impact their receptiveness to assistance with care and elicit challenging reactions to environmental and situational triggers. Unfortunately, current assessment tools fail to account for reactions to early-life trauma. In this article, we review existing literature on early-life trauma and aging and introduce a hypothetical case to illustrate the importance of identifying nursing home residents with past trauma experiences.
TL;DR: Assisted living administrators' perspectives of the role and the importance of the AL social worker in addressing the unmet needs of older adults as they move and transition into AL are reported on.
Abstract: This qualitative study reports on thirteen assisted living (AL) administrators' perspectives of the role and the importance of the AL social worker in addressing the unmet needs of older adults as they move and transition into AL. Participant interviews were analyzed using the constant comparative method. Administrators described 5 AL social work roles: (a) decision-making and adjustment coordinator; (b) resident advocate; (c) mental health assessor and counselor; (d) family social worker; and (e) care planner. Implications include directly examining AL social workers' views, analyzing costs and benefits of employing AL social workers, and developing social work practicum sites within AL.
TL;DR: The results illustrate critical periods for social work intervention with families of dying nursing home residents and the living–dying interval.
Abstract: Guided by concepts from the living-dying interval ( Pattison, 1977 ) this study sought to explore family members' experiences with a dying nursing home resident. In-depth interviews were conducted with 31 caregivers of residents who had died. Interviews were audiotaped and transcribed. Themes that illuminated families' experiences on the living-dying interval were: an acute medical crisis (trigger events, accumulation of stressors, level of care crisis); the living-dying phase (advance care planning, hospitalization, end-stage decisions); and the terminal phase (beginning of the end, awareness of dying). The results illustrate critical periods for social work intervention with families of dying nursing home residents.
TL;DR: Factors that contribute to the vulnerability of older adults in times of disaster are considered and some considerations that might inform social work contribution to disaster preparedness and response are outlined.
Abstract: After the devastating earthquake in Christchurch we all feel vulnerable here in New Zealand, but as reports from Tokyo remind us, when it comes to disasters, older adults are most vulnerable of all...
TL;DR: Based on in-depth interviews of 18 low- and moderate income older adults who were nominated as being wise by their aging-service providers, the ways challenging life experiences and coping may have contributed to the development of their wisdom, their ideas/bel beliefs about the qualities of wisdom, and the ways they may be practicing wisdom in daily life are explored.
Abstract: Previous wisdom research tended to focus on cognitive and intellectual aspects, highly educated professionals and/or prominent subjects, and wisdom as the outcome not process. In this study, based on in-depth interviews of 18 low- and moderate income older adults who were nominated as being wise by their aging-service providers, we explored the ways challenging life experiences and coping may have contributed to the development of their wisdom, their ideas/beliefs about the qualities of wisdom, and the ways they may be practicing wisdom in daily life. Their emphasis on interconnectedness and interdependence, forgiveness and patience, and gratitude appears to represent self-transcendental qualities of wisdom. Social work practice and research implications are discussed.
TL;DR: Service professionals' perceptions of how and why older adults and younger persons with disabilities are different consumers and clients within the long-term care service sector are explored.
Abstract: This study explores service professionals' perceptions of how and why older adults and younger persons with disabilities are different consumers and clients within the long-term care service sector Data are from 2004, early in the history of federal long-term care rebalancing initiatives, reflecting perceptions at that time Findings suggest professionals working within aging, developmental disability, and physical disability service networks believe significant distinctions exist related to age of clients and nature of service required and how it is delivered Overall need for greater professional and organizational capacity to support provision of service to both aging and disability populations is reported
TL;DR: Quality of relationship was the most significant variable in explaining both caregiving burden and caregiving satisfaction, yet different sets of additional variables were found to explain each of the outcomes.
Abstract: Research on the impact of quality of relationships between primary caregivers and their care recipients on burden and satisfaction with caregiving is still rare. The sample included 335 dyads of primary caregivers and care recipients who were cognitively intact. Face-to-face interviews were conducted at the respondents' homes using structured questionnaires. No significant correlation between caregiving burden and caregiving satisfaction was found. Quality of relationship was the most significant variable in explaining both caregiving burden and caregiving satisfaction, yet different sets of additional variables were found to explain each of the outcomes. Interventions should address quality of relationships in order to reduce burden and increase caregiving satisfaction.
TL;DR: The findings demonstrate the complexity of participants' responses to age-related changes, particularly in how they adapted and negotiated both their perception and life goals when faced with changing social landscapes.
Abstract: This qualitative study of 45 older adults examines how they allocate their resources in the face of chronic health conditions. Participants were recruited from 2 senior centers and interviewed about their repertoire of activities, any changes in those activities in later life, and meanings they ascribed to those changes. The Selection, Optimization, and Compensation model guided our analysis and interpretation of participants' responses. The findings demonstrate the complexity of participants' responses to age-related changes, particularly in how they adapted and negotiated both their perception and life goals when faced with changing social landscapes. We discuss some implications and nuances of our findings.
TL;DR: The study presents a social context in which African American seniors constructed their new third age identities that is different from the wide-spread negative images depicted by the mainstream about this minority group.
Abstract: This article examines the contexts and benefits of African American seniors' participation in multipurpose facilities. Using qualitative data from 15 in-depth participant interviews and 6-month on-site participant observations as well as a survey result, research revealed the physical, emotional, and social benefits that African American seniors reported as a result of their participation in various activities offered in a multipurpose senior center in Atlanta Georgia. The study presents a social context in which African American seniors constructed their new third age identities that is different from the wide-spread negative images depicted by the mainstream about this minority group. Findings from this study increase the knowledge about African American seniors' participation in multipurpose facilities and provide a better understanding for the diverse socio-economic backgrounds of African American seniors. Study results will have policy implications for a better development of senior centers for minority population in the United States for the promotion of productive and successful aging.
TL;DR: Middle-aged and older adults with multiple sclerosis according to their use of support groups and identified factors associated with perceived need were compared to raise questions for professionals involved in developing and implementing multiple sclerosis support groups.
Abstract: This study compared middle-aged and older adults with multiple sclerosis (MS, N = 1,275) according to their use of support groups and identified factors associated with perceived need. Over 64.6% (n = 824) of participants had attended a MS support group meeting at least once. Individuals who had never attended a group were more likely to reside in urban or suburban communities, report lower symptom interference, and fewer activity limitations. Women, individuals without a helper, and people with greater symptom interference were more likely to perceive a need for a support group. Findings raise questions for professionals involved in developing and implementing multiple sclerosis support groups.
TL;DR: Results emphasize the importance of peer relationships and suggest that, in some groups of older adults, social isolation may not be a hallmark of depressive symptoms.
Abstract: Social isolation and inadequate social support have been identified as correlates of depression in older adults, although the relationship between depression and social isolation is not entirely understood (Dorfman et al., 1995). This study was conducted to describe the social networks of depressed older adults living in the community and to compare the social networks of depressed and nondepressed individuals, thus adding to the body of knowledge regarding social networks, older adults, and depression. The sample consisted of 91 respondents aged 65 and older who were randomly selected using the voter registry. About 27% (25) respondents reported significant levels of depressive symptomology as measured by the Center for Epidemiological Studies-Depression Scale (CES-D). All respondents completed semistructured interviews that included questions about social contacts with family and others during the prior week. All participants reported social contact with family and friends during this period. In this sample, depressed elders were not socially isolated. They were more likely to report contacts with friends than those who were not depressed, and equally likely to report involvement in volunteer activities. Their likelihood of seeking social support was also comparable. Results emphasize the importance of peer relationships and suggest that, in some groups of older adults, social isolation may not be a hallmark of depressive symptoms.
TL;DR: Results suggest that the educational model as described in this article sets forth positive outcomes in the education of aging savvy social workers.
Abstract: Social workers are often the key link between older adults, their families and community-based services. Thus, knowledge about older adults and community-based care is imperative for social work practice. Evaluation data are provided on a national multisite effort (N = 353) from 35 schools to assure graduate social work student's competency related to community services for older adults. Results suggest that the educational model as described in this article sets forth positive outcomes in the education of aging savvy social workers. Ongoing social work education is needed to meet the burgeoning needs of the geriatric population.
TL;DR: Critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment for homebound older adults.
Abstract: Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.
TL;DR: Using PST in primary care may facilitate patients in addressing key health and wellness issues, and factors associated with successful problem resolution are explored.
Abstract: This article describes problems identified by older primary care patients enrolled in Problem Solving Therapy (PST), and explores factors associated with successful problem resolution. PST patients received 1 to 8, 45-min sessions with a social worker. Patients identified problems in their lives and directed the focus of subsequent sessions as consistent with the steps of PST. The 107 patients identified 568 problems, 59% of which were resolved. Most commonly identified problems included health related issues such as need for exercise or weight loss activities, medical care and medical equipment needs, home and garden maintenance, and gathering information on their medical condition. Problems identified by patients were 2.2 times more likely to be solved than those identified by a health care professional. Using PST in primary care may facilitate patients in addressing key health and wellness issues.
TL;DR: Living in a CCRC appears to be associated with higher self-ratings of health in this sample, and there were no significant differences in frequency of home health use or hospitalization.
Abstract: Little is known about the health status of adults living in continuing care retirement communities (CCRC). Using matched-case control, 458 adults from the Health and Retirement Study (HRS) or a CCRC-based sample were compared on total comorbidity, self-rated health, home health services use, and hospitalizations. At year 2, the CCRC sample reported more comorbidities (96%) but significantly better self-rated health (96% good/excellent) than the HRS sample (93% comorbidity, 73% good/excellent; p < .01). There were no significant differences in frequency of home health use or hospitalization. Living in a CCRC appears to be associated with higher self-ratings of health in this sample.
TL;DR: A retrospective analysis of written court records and audiotapes of court testimony for adult guardianship cases in 2 Kentucky counties was conducted to learn how interdisciplinary assessment teams contributed to the guardianship process for older adults.
Abstract: A retrospective analysis of written court records and audiotapes of court testimony for adult guardianship cases in 2 Kentucky counties was conducted. Two hundred forty clinical assessments were reviewed for 80 court petitions. The purpose of this research was to learn how interdisciplinary assessment teams contributed to the guardianship process for older adults. Guardianship assessments and court testimony were reviewed to explore the comprehensiveness of reports to the court, the consideration of less restrictive alternatives, and the use of limited guardianships. Recommendations are given for ways in which social workers can improve information given to the courts and advocate for elders in this situation. The role of social work in this national phenomenon is discussed.
TL;DR: Responses reflected four distinct approaches to ER use, which are characterized by frequency (frequent/infrequent) and risk for social isolation (low/high).
Abstract: Increasing use in the past decade has created pressure for hospital emergency rooms (ERs). Healthcare provided through an ER is expensive and is not designed to meet the complex needs of an older, chronically-ill population. ER visits are presented as the outcome of a decision-making process. Thirty veterans who had visited the ER in the previous year were asked about their decisions to use the ER. Their responses reflected four distinct approaches to ER use, which are characterized by frequency (frequent/infrequent) and risk for social isolation (low/high). Appropriate interventions by social work personnel might reduce inappropriate use of the ER and enhance the care of this vulnerable population.