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- Go to article: Care Needs of Older Broome County Residents: A Survey of Elders Receiving Care Through the Continuum
Using data from the National Survey of Homeless Assistance Providers and Clients (NSHAPC), this article examines the applicability of Felson’s Routine Activities Theory to a national probability sample of older homeless individuals. Results indicate that the relative protection that women often have from most crimes is not transferred to the older homeless woman who is more likely than her male counterparts to be the victim of sexual assault but equally as likely to be the victim of theft and physical assault. Likewise, the protection often noted afforded by age against victimization is also not seen among the homeless. The research demonstrates that being male and having mental and physical health problems as well as substance abuse problems increases the likelihood of victimizations among the homeless population, in general. When predictors of victimization were considered for the 50 and older sample, these predictors remained the same except that the gender remained significant only for sexual assault. These findings are consistent with and supportive of utilizing Felson’s Routine Activities Theory to understand and explain victimization among the older homeless population.
- Go to article: Identifying Older Adults at Risk for Depression in Senior Centers: The Educating About and Screening Elders for Depression Model
Case mangers must deal with the ever-changing makeup of their client population as well as those who provide managed services to these clients. There is great ethnocultural diversity in the elder population, and statistics contend that it will only increase with time. Similarly, the majority of long-term-care providers have been consistently female and of color. Providing culturally competent services becomes more complex when long-term-care providers and clients possess different identities, countries of origins, and social statuses. This article examines a framework that addresses the complex, multidimensional, and bidirectional process that occurs between providers and consumers of any cultural makeup called cultural responsiveness.
There is little literature about the relationships of older women who live alone and the paid, nonprofessional helpers who assist them. Studies of interpersonal trust have focused on the vulnerability of the trusting person and actions of the trusted person. The actions of the trusting person, or empirical indicators of trust, have had little attention. Our purpose was to describe the actions of older women that were indicative of their trust in nonprofessional home-care helpers. In a descriptive phenomenological study of 25 older widows, a subsample of 11 women who had hired nonprofessional helpers reported actions toward the helpers that we deemed markers of trust. The overarching marker of trust was keeping my eyes off of the helper, with five subsidiary markers, including allowing the helper to enter my house at will. Findings extend empirical knowledge about trust, raise new questions about interpersonal theories of trust, and suggest further areas of study.
This article is about the importance of retaining a focus on the humanity of older adults while rendering care to them through community and long-term care services. It is written from my experience as a director of a community service (Adult Day Health Care [ADHC] program), a program officer at a foundation devoted to improving health care for older Americans, a researcher who spent years conducting interviews with staff workers in long-term care services, and from the perspective of a professional and personal caregiver and friend to many elders living in the community—in their own homes and in nursing homes. From these diverse professional and personal roles and perspectives, I have learned that the formation of authentic human relationships, which go beyond the routine medical, nursing, and social work approach to care, can play a vital role in healing and addressing loneliness in elders—and transform the lives of their personal and professional caregivers as well. A focus on humanity need not cost money or place a heavy demand on the worker. In fact, it can be one of the most cost-effective approaches to improving quality in health care, attracting workers to the field of long-term care, and boosting the morale of both caregivers and care recipients.
- Go to article: Social Withdrawal of Persons With Vascular Dementia Associated With Disturbance of Basic Daily Activities, Apathy, and Impaired Social Judgment
Social Withdrawal of Persons With Vascular Dementia Associated With Disturbance of Basic Daily Activities, Apathy, and Impaired Social Judgment
Patients with vascular dementia (VaD) are often isolated, withdrawn from society because of negative symptoms and functional disabilities. The aim of this study was to detect factors associated with social withdrawal in patients with VaD. The participants were 36 institutionalized patients with VaD. Social withdrawal was assessed with the social withdrawal of the Multidimensional Observation Scale for Elderly Subjects (MOSES). Possible explanatory variables were the MOSES items depression and self-care, Cognitive Abilities Screening Instrument (CASI), apathy evaluation scale (AES), and Behavioral Pathology in Alzheimer’s Disease Frequency-Weighted Severity Scale (BEHAVE-ADFW). Multiple regression analyses were conducted for two groups: Analysis 1 was performed in all patients (N = 36) and Analysis 2 was performed in the patients with the ability to move by themselves (i.e., independent walking or independent movement with a cane or a wheelchair; n = 28). In Analysis 1, MOSES item social withdrawal was correlated with AES and MOSES item self-care. In Analysis 2, MOSES item social withdrawal was correlated with AES and CASI domain abstraction and judgment. Decreased social activities of VaD were not related to general cognitive function or depression. Disturbed activities of daily living (ADLs) for self-care may involve decreased frontal lobe function, indicating that comprehensive rehabilitation for both ADL and dementia are needed to improve the social activities of patients with VaD.
- Go to article: 6.4 Million at Risk: Protecting the Poorest Americans During the Medicare Drug Transition