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Your search for all content returned 1,387 results

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  • Project FIND: A Profile of a Community-Based Senior Services AgencyGo to article: Project FIND: A Profile of a Community-Based Senior Services Agency

    Project FIND: A Profile of a Community-Based Senior Services Agency

    Article

    Project FIND has been providing innovative supportive housing, nutrition, and social support to homeless and low- and moderate-income seniors on New York City’s West Side since 1967. This article profiles this nonprofit, community-based agency, which was established to meet the needs of the frail and isolated elderly, and has continued to grow and evolve in response to changing demographics, neighborhood gentrification, and needs of both the homeless as well as the active “younger old.” The article describes creative programming that has distinguished Project FIND’s response to seniors’ needs beyond basic housing and nutrition. It also explores what it takes to successfully provide senior services using limited resources and examines challenges for the future both nationally and for the agency.

    Source:
    Care Management Journals
  • Employer Practices in Improving Employment Outcomes for People With Disabilities: A Transdisciplinary and Employer-Inclusive Research ApproachGo to article: Employer Practices in Improving Employment Outcomes for People With Disabilities: A Transdisciplinary and Employer-Inclusive Research Approach

    Employer Practices in Improving Employment Outcomes for People With Disabilities: A Transdisciplinary and Employer-Inclusive Research Approach

    Article

    Objective: Share new knowledge about workplace practices related to employer success in hiring, retaining, and promoting people with disabilities, and promote use of findings to employers and service providers.

    Design: A transdisciplinary and multifaceted data gathering approach.

    Results: Provides an overview of the research approach taken and the strengths regarding this approach.

    Conclusions: The significance of findings for rehabilitation researchers and policy makers focused on improving employment outcomes for people with disabilities, for rehabilitation counselor educators preparing future service providers, and for practicing professionals providing services to individuals with disabilities and consultation to employers regarding disability issues, are presented.

    Source:
    Rehabilitation Research, Policy, and Education
  • Etiology of Individual Differences in Human Health and LongevityGo to article: Etiology of Individual Differences in Human Health and Longevity

    Etiology of Individual Differences in Human Health and Longevity

    Article

    In this chapter, we review of the field of gerontological genetics with respect to subjective and objective health, the role of stress on health, and finally frailty and longevity. For most indices of subjective and objective health, frailty, and longevity, genetic influences contribute only modestly to individual differences, wherein heritabilities are typically on the order of 35%–40%. Notable exceptions are the moderate to strong heritabilities for lipid measures and brain structure and function, with a remarkably increasing role of genetic influences for longevity with advancing age. Although candidate gene and genome-wide association studies (GWAS) studies have identified gene variants associated with many subjective and objective health traits, their effect sizes are typically relatively small, as expected for complex traits. There is some evidence for gene–environment interactions, and stress may be an important moderator of genetic variance for health. For example, carrying a risk genotype for cardiovascular disease (CVD) in the angiotensin converting enzyme gene (

    Source:
    Annual Review of Gerontology and Geriatrics
  • Changing Negative Views of Aging: Implications for Intervention and Translational ResearchGo to article: Changing Negative Views of Aging: Implications for Intervention and Translational Research

    Changing Negative Views of Aging: Implications for Intervention and Translational Research

    Article

    In most Western societies, the perception of age and aging is predominantly negative, and this negativity is often integrated into older adults' self-view of age(ing). At the societal level, negative views of aging manifest themselves in the form of age stereotypes, which result in prejudice and discrimination toward older adults. At the personal level, negative views of one's own aging are related, among others, to poor health, lower well-being, and even shorter survival times. Considering these negative effects, interventions that promote positive views of aging seem warranted. This chapter discusses potential routes for changing negative (self-)views of aging and the challenges that are inherent to such efforts, such as determining and reaching the target groups for intervention programs. Strategies such as increasing the knowledge about old age, providing opportunities for children or younger adults to interact with older adults, as well as changing the portrayal of older adults in the media might be used to change societal views of aging. Because it is assumed that for some older adults age stereotypes become self-stereotypes, changing the societal view of aging might eventually also lead to a positive change in older adults' view of their own aging, and it might minimize the burden of belonging to a stigmatized group. Few strategies for changing personal views of aging (e.g., social comparison feedback) have been shown to be successful so far. Overall, more research is necessary to develop interventions which are easy to implement and universally effective.

    Source:
    Annual Review of Gerontology and Geriatrics
  • A Home Health Care Approach to Exercise for Persons With Alzheimer’s DiseaseGo to article: A Home Health Care Approach to Exercise for Persons With Alzheimer’s Disease

    A Home Health Care Approach to Exercise for Persons With Alzheimer’s Disease

    Article

    Regular exercise is a mainstay of preventive health care for individuals of all ages. Research with older adults has shown that exercise reduces risk of chronic illness, maintains mobility and function, enhances mood, and may even improve cognitive function. For individuals with dementia, exercise programs are particularly likely to improve health, mood, and quality of life; the challenge at this time is to make exercise accessible and enjoyable, demonstrate its benefits, and convince family caregivers of its worth for individuals with dementia. Home health providers are uniquely positioned to assist caregivers in developing and implementing a home exercise program for their care recipient with dementia. Results of a controlled critical trial conducted at the University of Washington have demonstrated the feasibility and efficacy of a home health exercise and problem solving intervention (Reducing Disability in Alzheimer’s Disease, or RDAD) for decreasing physical, psychological, and behavioral disabilities associated with dementia. This article describes the RDAD program, discusses the role of home health providers in its delivery, and provides an example of its implementation.

    Source:
    Care Management Journals
  • Emerging Perspectives on Resilience in Adulthood and Later Life: Work, Retirement, and ResilienceGo to article: Emerging Perspectives on Resilience in Adulthood and Later Life: Work, Retirement, and Resilience

    Emerging Perspectives on Resilience in Adulthood and Later Life: Work, Retirement, and Resilience

    Article

    Continued employment of the adult and older adult worker requires resilience in response to growing levels of workplace, demand, and adversity. Four patterns of resilience are considered including dispositional, relational, situational, and philosophical. Life span theory and approaches to developmental change are discussed in the context of resilience and working in later life. Changes in work demands, health, injury and disability, skills and abilities needed, employment and reemployment, organizational culture, as well as worker purpose and fulfillment are included in this overview.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Aching to be Understood: Vocational Rehabilitation Implications for Emerging Adults in Chronic PainGo to article: Aching to be Understood: Vocational Rehabilitation Implications for Emerging Adults in Chronic Pain

    Aching to be Understood: Vocational Rehabilitation Implications for Emerging Adults in Chronic Pain

    Article

    Background

    Emerging adults, the developmental period ranging from the late teens through the 20s, experience chronic pain at an estimated rate of 7.6%–14.3% and report greater pain interference (i.e., pain that disrupts daily life activities) than middle-aged or older adults. Chronic pain can interfere with the completion of developmental tasks associated with biological, psychological, occupational, and social changes necessary to move from emerging adulthood into young adulthood. For these reasons, the impact of chronic pain may be more detrimental for emerging adults than for middle-aged and older adults.

    Objective

    To investigate the unique characteristics and vocational rehabilitation needs of emerging adults with chronic pain and to identify and implement policies, practices, and interventions that facilitate the achievement of vocational rehabilitation consumer’s self-determined goals.

    Methods

    The authors reviewed the literature on (a) common conditions that cause chronic pain in emerging adults, (b) the populations most at risk of experiencing chronic pain in emerging adulthood, (c) psychosocial aspects of chronic pain for this population, (d) vocational impact of chronic pain on emerging adults, and (e) the use of the disability centrality model to guide assessment and planning.

    Conclusion

    This literature review examines best practices related to vocational rehabilitation and emerging adults living with chronic pain. Comprehensive recommendations are provided that inform all phases of the vocational rehabilitation planning process, including services related to outreach and eligibility, counseling and guidance, physical and mental restoration, post-secondary education, job development and placement, and accommodation planning.

    Source:
    Rehabilitation Research, Policy, and Education
  • Perceived Health and Functional Status and Work Environmental Factors as Determinants of Psychological Stress Among Employed People With Multiple SclerosisGo to article: Perceived Health and Functional Status and Work Environmental Factors as Determinants of Psychological Stress Among Employed People With Multiple Sclerosis

    Perceived Health and Functional Status and Work Environmental Factors as Determinants of Psychological Stress Among Employed People With Multiple Sclerosis

    Article

    Purpose

    This correlational study examined relationships among (a) health and function factors, (b) work environmental factors, and (c) perceived psychological stress among employed people with multiple sclerosis (MS).

    Method

    Based on responses to a national survey by 523 employed people with MS, this study used a hierarchical multiple regression analysis.

    Results

    The final model explained 30% of the variability in participants' perceived stress scores. Participants who perceived better overall health, who experienced less severe cognitive impairment, who expressed higher levels of job satisfaction, and who did not receive accommodations at work reported lower stress scores than did other participants.

    Implications

    The important role of stress in employment and career decision-making underscores the value of tailored psychosocial, medical, and vocational interventions for employed people with MS.

    Source:
    Rehabilitation Research, Policy, and Education
  • Relationships Between Positive Human Traits and PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishments) in Student Veterans With and Without Disabilities: A Canonical Correlation AnalysisGo to article: Relationships Between Positive Human Traits and PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishments) in Student Veterans With and Without Disabilities: A Canonical Correlation Analysis

    Relationships Between Positive Human Traits and PERMA (Positive Emotion, Engagement, Relationships, Meaning, and Accomplishments) in Student Veterans With and Without Disabilities: A Canonical Correlation Analysis

    Article

    Purpose

    We explored the relationships between positive human traits and positive emotions, engagement, relationships, meaning, and achievement (PERMA) the core elements for Seligman's model of happiness and well-being.

    Method

    Two hundred and five student veterans (147 males and 58 females; 80 with service-related disability) were recruited from several colleges and universities across the United States. Participants completed positive human traits measures on resilience, hope, optimism, attachment, and coping, along with the PERMA Profiler that measures the five core elements of the well-being theory. Correlational techniques and canonical correlation analysis were computed to examine the canonical relationship between positive human traits and PERMA variables.

    Results

    Overall, the positive human traits set accounted for 37% of the variance in the PERMA set, whereas the PERMA set accounted for 51% of the variance in the positive human traits set.

    Conclusions

    The research findings suggest that human traits can be conceptualized as building blocks for PERMA, and PERMA are the core elements for happiness and well-being. Importantly, student veterans with disabilities had significantly lower resilience, secure attachment and PERMA scores. Positive psychology interventions to help student veterans, especially students with service-related disabilities, develop character strengths, and PERMA could improve college life adjustment and goal persistence of student veterans.

    Source:
    Rehabilitation Research, Policy, and Education
  • Test Equity for People who are Deaf or Hard-of-Hearing: Commission on Rehabilitation Counselor Certification Steps for ImplementationGo to article: Test Equity for People who are Deaf or Hard-of-Hearing: Commission on Rehabilitation Counselor Certification Steps for Implementation

    Test Equity for People who are Deaf or Hard-of-Hearing: Commission on Rehabilitation Counselor Certification Steps for Implementation

    Article

    The Commission on Rehabilitation Counselor Certification (CRCC) has taken a proactive stance on perceived test inequities of the Certified Rehabilitation Counselor (CRC) exam as it relates to people who are prelingually deaf and hard of hearing. This article describes the process developed and implemented by the CRCC to help maximize test equity for this target group. Using recommendations from a group of national experts in deafness and rehabilitation, focus groups examined exam items considered linguistically difficult items for people who are deaf or hard of hearing and, from that effort, developed guidelines that could be used to address linguistic complexity concerns for future test items.

    Source:
    Rehabilitation Research, Policy, and Education
  • A Review of Intimate Partner Violence for Case ManagersGo to article: A Review of Intimate Partner Violence for Case Managers

    A Review of Intimate Partner Violence for Case Managers

    Article

    This article provides case managers with updated information on intimate partner violence. Case managers provide an important role in the identification, treatment, and prevention of intimate partner violence. Current federal laws provide direction and funding for a complex network of services for survivors. Effective identification involves screening and assessing risk of harm, severity of violence, and the survivor’s readiness for change. Care planning involves working with the survivor and their families to build protective skills, make a safety plan, and build their life independent of violence.

    Source:
    Care Management Journals
  • The Role of Community and the Environment in the Lives of Older PeopleGo to article: The Role of Community and the Environment in the Lives of Older People

    The Role of Community and the Environment in the Lives of Older People

    Article

    This chapter provides an overview of the various strands of my research on community and environmental perspectives on aging and later life. Following an outline of biographical influences and early work in critical gerontology, the chapter provides examples from research (with a variety of colleagues) covering themes relating to family and community life in old age, the impact of social exclusion, and the development of transnational communities. The chapter then reviews subsequent work on the impact of globalization on urban life, and research on the theme of “age-friendly cities.” The chapter concludes with a summary of future research agendas for Environmental Gerontology.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Availing Reasonable Accommodations for College Students With Psychiatric Disabilities: Findings From a Qualitative StudyGo to article: Availing Reasonable Accommodations for College Students With Psychiatric Disabilities: Findings From a Qualitative Study

    Availing Reasonable Accommodations for College Students With Psychiatric Disabilities: Findings From a Qualitative Study

    Article

    Purpose

    As many as half of all college students meet DSM-5 criteria for a mental illness; less than 5% report the ability to successfully navigate and complete their degrees. This is in part due to the lack of knowledge of reasonable accommodations for psychiatric disabilities.

    Method

    In the current study, we conducted qualitative interviews with students and faculty to identify types of reasonable accommodations students receive for their mental illness and factors that influence their ability to avail these accommodations.

    Results

    Factors included lack of awareness of accommodations, achieving fairness between students, and using accommodations as a disclosure tool.

    Conclusions

    Higher education institutions should better support the awareness training on accommodations for both faculty and staff. Self-advocacy training is recommended to help students in disclosing mental illness, requesting accommodations, and managing negative social reactions. Perhaps in vivo coaching is a promising tool to accommodate emotional and interpersonal disabilities.

    Source:
    Rehabilitation Research, Policy, and Education
  • Community-Based Case Management and Health Care Use in Older Adults: Outcomes of a Collaborative Multiagency ApproachGo to article: Community-Based Case Management and Health Care Use in Older Adults: Outcomes of a Collaborative Multiagency Approach

    Community-Based Case Management and Health Care Use in Older Adults: Outcomes of a Collaborative Multiagency Approach

    Article

    Case management (CM) establishes valuable connections between clients and needed supports. There are, however, mixed results on its prediction of health care use. This quasi-experimental record review (N = 96) of a collaborative CM consortium examined predictors of health care use among older adults (aged older than 60 years) who had received CM for at least 6 months. Descriptive, bivariate, and multivariate models were used to predict differences in outcomes (hospitalization and emergency room [ER] visits) between participants who received CM and those who did not. Hospitalization rates were significantly lower among CM recipients. Living alone, identifying as White/non-Hispanic, and higher numbers of medications were significant copredictors of hospital use. CM was not a significant predictor of ER use. Race/ethnicity, however, remained significant in that White/non-Hispanic participants were 4 times likely to have at least 1 ER visit than persons of color. Implications for future research are discussed to promote better understanding of the effectiveness of CM, particularly within ethnically and racially diverse communities. Further inquiry is needed around the experiences of older adults of color, those who live alone, or who take multiple medications as needed. Further testing of a consortium model is necessary to determine value added through a multiagency approach.

    Source:
    Care Management Journals
  • Expressions of Identity and Self in Daily Life at a Group Home for Older Persons With Dementia in JapanGo to article: Expressions of Identity and Self in Daily Life at a Group Home for Older Persons With Dementia in Japan

    Expressions of Identity and Self in Daily Life at a Group Home for Older Persons With Dementia in Japan

    Article

    This study focuses on expressions of identity and self among residents at a group home for older persons with dementia in Japan—a study, which started as an explorative study on spirituality—and how residents make meaning of life. Although aware of stages of dementia illness and briefly commenting on these, the analysis does not make any specific point of it. This article views dementia from a sociocultural perspective and is based on participant observations at a group home with 19 residents, combined with interviews with 6 of them. Two central concepts for the study are discussed and drawn on in the analysis: ie, meaning home and family, and dementia and boke, senility. The study examines how the group home is ie and concludes that it is “home enough” in the sense that one’s identity and self are honored here. The old word boke represents a state in which one has “given up” any attempts to keep one’s mental health. This concept was used by some residents to mark the line between those who were “helpless” with boke and those who could manage by themselves without boke. Identities are analyzed in different terms: as profession, as feeling secure, as being physically close, in social interactions, and as being cared for properly also after death. The analysis of self and identity showed that contentment in life was expressed in various ways, as a whole or as a patchwork with light and dark colors, and that it is still in process. Here, the supportive but discreet scaffolding of staff seems to matter. Life is lived until death, and the farewell ceremonies are analyzed as existential closures for many—and for life finalized here at Ie, the group home.

    Source:
    Care Management Journals
  • The Analysis for the Causes of Surgical Cancellations in a Brazilian University HospitalGo to article: The Analysis for the Causes of Surgical Cancellations in a Brazilian University Hospital

    The Analysis for the Causes of Surgical Cancellations in a Brazilian University Hospital

    Article

    Background: The aim of our study is to quantify the occurrence of suspension of scheduled surgeries in a Brazilian university hospital, trying to identify the causes of suspension of these operations and meet the medical specialties that most contributed to the cancellation.

    Methods: This study takes the form of an exploratory, descriptive, and quantitative enquiry carried out by analyzing the database from 2008 to 2011 of the operating theater.

    Results: Of the 29,518 scheduled surgeries, 16.1% were cancelled. The patient was the main reason, accounting for more than 40% of all suspensions. When calculating the rate of surgery suspended from a specialty, dividing the number of cancelled surgeries in a specialty by the number of scheduled surgeries in the same, we found that otolaryngology is the specialty with the highest rate of 21.3%.

    Conclusions: One of the main reasons in our sample why surgeries were cancelled is nonappearance of the patient. Improving communication between patient and hospital facilitates the client program and also contributes to avoid cancellations.

    Source:
    Care Management Journals
  • Participation and Psychological Capital in Adults With Parkinson's Disease: Mediation Analysis Based on the International Classification of Functioning, Disability, and HealthGo to article: Participation and Psychological Capital in Adults With Parkinson's Disease: Mediation Analysis Based on the International Classification of Functioning, Disability, and Health

    Participation and Psychological Capital in Adults With Parkinson's Disease: Mediation Analysis Based on the International Classification of Functioning, Disability, and Health

    Article

    Objective

    The purpose of this study was to explore how the functional impact of Parkinson's disease affects participation and to evaluate whether positive psychological capital (PsyCap) mediates the relationship within the context of the World Health Organization International Classification of Functioning, Disability, and Health Model.

    Method

    Survey responses were analyzed from 144 adults with Parkinson's disease using a quantitative, correlational research design employing multiple regression and hierarchical regression analysis to examine hypothesized relationships.

    Results

    The results of the correlation analysis indicated that there was a statistically significant, moderate-to-strong positive correlation between functioning and PsyCap and participation. Hierarchical regression analysis revealed that functioning accounted for 65% of the variance in participation. Although PsyCap was associated with participation, no mediating effect was observed.

    Conclusions

    The results are consistent with traditional clinical judgment that physical functioning is positively correlated with participation. This study represents the first evaluation of the role of PsyCap in people with Parkinson's disease, and the results of the correlational analysis suggest that continued investigation of these relationships is warranted.

    Background

    Parkinson's disease results in a variety of motor and non-motor features that frequently result in reduced participation in valued life activities.

    Source:
    Rehabilitation Research, Policy, and Education
  • Accommodation Requests: Who Is Asking for What?Go to article: Accommodation Requests: Who Is Asking for What?

    Accommodation Requests: Who Is Asking for What?

    Article

    Purpose: Workplace accommodations are central to improving employment outcomes for people with and without disabilities; this study presents national estimates comparing accommodation requests and receipt as reported by individuals with and without disabilities.

    Method: Estimates are developed from the May 2012 Current Population Survey Disability Supplement.

    Results: The findings highlight variability in accommodation requests by disability type and status. Accommodation request rates are also presented by occupation and industry groups.

    Conclusions: As employers voice concerns about the additional burden of employing individuals with disabilities under new regulatory requirements, our findings highlight that 95% of individuals requesting an accommodation were people without disabilities.

    Source:
    Rehabilitation Research, Policy, and Education
  • Exploring the Relationship Between Familiarity With the ICF and Rehabilitation Counselor Confidence in Facilitating Workplace AccommodationsGo to article: Exploring the Relationship Between Familiarity With the ICF and Rehabilitation Counselor Confidence in Facilitating Workplace Accommodations

    Exploring the Relationship Between Familiarity With the ICF and Rehabilitation Counselor Confidence in Facilitating Workplace Accommodations

    Article

    Purpose

    The International Classification of Functioning (ICF) provides a framework for understanding and accommodating disability. This study examined predictors and outcomes of ICF familiarity among rehabilitation counselors.

    Method

    Analysis of variance and hierarchical regression analysis were used to examine research questions related to ICF familiarity.

    Results

    Rehabilitation counselors with five or fewer years of experience were more familiar with the ICF. Analysis showed familiarity with the ICF positively correlated with greater confidence in recommending work accommodations.

    Conclusions

    Data supports use of the ICF in rehabilitation counseling. Emphasizing the ICF in specific courses (e.g., medical aspects of disability, career and vocational development) may support improved practice.

    Source:
    Rehabilitation Research, Policy, and Education
  • Survey of Community-Based Programs Serving U.S. Families With Huntington’s Disease: Perceived Barriers and Facilitators in the Residential Placement ProcessGo to article: Survey of Community-Based Programs Serving U.S. Families With Huntington’s Disease: Perceived Barriers and Facilitators in the Residential Placement Process

    Survey of Community-Based Programs Serving U.S. Families With Huntington’s Disease: Perceived Barriers and Facilitators in the Residential Placement Process

    Article

    This article describes the contours of the residential care placement experience for social service staff, health care providers, and their client families of patients with Huntington’s disease. The purpose of this study was to determine the factors, conditions, and barriers encountered by outpatient clinical staff and families in the transition to skilled nursing care. A Long-Term Care Contact Survey was developed to (a) gather information about long-term care referral sites; (b) determine the factors considered in choosing a facility; (c) describe the factors that hindered the transition to long-term care; (d) describe conditions prior to institutionalization; and (e) determine research interest. The study found that large cohorts of patients with Huntington’s disease in residential care are scarce. A lack of confidence in the available options suggests the need for increased support for educational and social services to facility staff. Speech/swallowing therapy and physical therapy as placement facilitators reflect salient issues of latter stages of the disease, implicating funding support needs. Families facing this transition require long-term guidance for financial, caregiving, and psychosocial issues.

    Source:
    Care Management Journals
  • Longitudinal Research on Subjective Aging, Health, and Longevity: Current Evidence and New Directions for ResearchGo to article: Longitudinal Research on Subjective Aging, Health, and Longevity: Current Evidence and New Directions for Research

    Longitudinal Research on Subjective Aging, Health, and Longevity: Current Evidence and New Directions for Research

    Article

    In this chapter, we carry out a narrative review of the longitudinal impact of subjective aging on health and survival. We have a specific focus on the different pathways which can explain the relation of subjective aging to health and survival. We focus on the three most common conceptualizations of subjective age: (a) age identity, (b) self-perceptions of aging, and (c) self-perceptions of age-related growth and decline. For each concept, we present the theoretical background, the empirical studies on the effects on health and survival, and conclude with the pathways which might explain these effects. The chapter ends with a heuristic model that synthesizes the theories and findings in describing how subjective aging is related to different psychological resources, which are in turn related to health and survival. Last, we provide some possible directions for further research in this area.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Evaluating a Self-Determination Model of Physical Activity and Exercise in People With Chronic Musculoskeletal PainGo to article: Evaluating a Self-Determination Model of Physical Activity and Exercise in People With Chronic Musculoskeletal Pain

    Evaluating a Self-Determination Model of Physical Activity and Exercise in People With Chronic Musculoskeletal Pain

    Article

    Background

    Research evidence supports the assertion that healthy employees are happier and more productive. Employers prefer to hire healthy workers to reduce absenteeism. Rehabilitation counselors have started to explore health promotion interventions to help individuals with chronic health conditions and disability improve their physical and mental health as a strategy to increase their employment opportunities.

    Purpose

    The present study evaluated a self-determination theory (SDT) model of physical activity and exercise in a sample of 218 individuals with chronic musculoskeletal pain using structural equation modeling.

    Results

    The SDT model fit the data well, accounting for 54% of the variance in physical activity and exercise. Relatedness was significantly associated with autonomous motivation for physical activity and exercise. Autonomous motivation was associated with competency. Competency was associated with physical activity and exercise. Autonomous motivation and competency mediated relatedness and physical activity and exercise.

    Implications

    This study contributes to an emerging body of theory-informed health promotion literature and identifies the specific pathways that will increase the motivation to engage in physical activity and exercise. Findings can be used to design and validate theory-driven health promotion interventions as an employment strategy for people with chronic musculoskeletal pain receiving vocational rehabilitation services.

    Source:
    Rehabilitation Research, Policy, and Education
  • Working With Clients Who Opt to Use Marijuana as an Alternative Treatment for Chronic Health ConditionsGo to article: Working With Clients Who Opt to Use Marijuana as an Alternative Treatment for Chronic Health Conditions

    Working With Clients Who Opt to Use Marijuana as an Alternative Treatment for Chronic Health Conditions

    Article

    Background

    Marijuana as an alternative treatment for chronic illnesses has gained popularity over the past several years, and researchers continue to report positive outcomes for a growing number of disorders.

    Objective

    To address the increasing number of individuals with disabilities using medicinal marijuana, this study sought to ascertain how rehabilitation professionals (RPs) respond when working with individuals who use this form of treatment. for chronic health conditions.

    Methods

    RPs were presented with two case scenarios depicting clients who were either currently using or considering using marijuana and were asked what steps they would take when working with this individual. Options included (a) dismiss the client; (b) counsel the client against using; (c) refer client to a mental health professional; (d) meet with the employer; (e) consult with the physician who would recommend medical marijuana for your client; (f) consult your supervisor; (g) consult your agency's policy on drug use; and (h) review the code of ethics for your profession.

    Findings

    No significant results were noted in scenario 1, however, participants were more likely to consult those who could increase their understanding of medicinal marijuana andthose who could help support their work with these clients In scenario 2, participants were significantly more likely to select meeting with the clients' employer, which speaks to the primary focus of RPs' work—-helping clients obtain and maintain employment.

    Conclusion

    There are far reaching implications for our work as RPs, including serving as valuable resources for clients who do not typically seek out vocational rehabilitation services.

    Source:
    Rehabilitation Research, Policy, and Education
  • Incorporating Function and Physical Activity Across All SettingsGo to article: Incorporating Function and Physical Activity Across All Settings

    Incorporating Function and Physical Activity Across All Settings

    Article

    The majority of older adults do not engage in regular physical activity. In surveys of community dwelling, among older adults age 75 and above, one in three men and one in two women engage in no physical activity. These rates are even lower among those who are hospitalized or institutionalized in nursing homes or assisted living settings. Moreover, those living in institutional settings demonstrate a decline in function that exceeds what would be expected based on disease states. Limited activity and functional decline place older adults at risk for pain associated with contractures, pressure sores, and decreased sense of well-being and overall quality of life. We propose a Function Focused Care approach that encourages caregivers to engage older adults in function and physical activity during all care interactions. This approach can be implemented using a fourstep approach and practical, cost-neutral approaches. This chapter delineates the ways in which to implement Function Focused Care across all settings, describes outcomes associated with this approach, and provides ways in which to overcome the setting-specific challenges.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Identifying a Transition Competency Domain Structure: Assisting Transition Planning Teams to Understand Roles and Responsibilities of Community PartnersGo to article: Identifying a Transition Competency Domain Structure: Assisting Transition Planning Teams to Understand Roles and Responsibilities of Community Partners

    Identifying a Transition Competency Domain Structure: Assisting Transition Planning Teams to Understand Roles and Responsibilities of Community Partners

    Article

    The special education and rehabilitation literature is replete with articles examining transition planning, services and supports; however, transition models have typically been developed for the school context and not focused on other transition team members. These school-based models are important; however, models developed from the perspectives of other key partners could provide valuable insight and enhance transition team functioning. Vocational Rehabilitation (VR) professionals are often the only link that transition programs have to employment; therefore, VR counselor perceptions of essential competency domains need to be understood by both school and adult agency professionals alike. This study collected data from 291 vocational rehabilitation (VR) counselors from three Midwestern states. Exploratory factor analysis was used to identify an underlying transition domain structure. Seven transition domains areas are presented and conferred. Implications and proposed directions for future research are discussed.

    Source:
    Rehabilitation Research, Policy, and Education
  • Examining the Relationships Between Social Determinants of Health and Health-Related Quality of Life Among Individuals Living With HIVGo to article: Examining the Relationships Between Social Determinants of Health and Health-Related Quality of Life Among Individuals Living With HIV

    Examining the Relationships Between Social Determinants of Health and Health-Related Quality of Life Among Individuals Living With HIV

    Article

    Purpose

    The current study examined the relationships between health-related quality of life (HRQOL) and social determinants of health (SDH), which are the individual and structural factors that contribute to health outcomes.

    Method

    A hierarchical general linear model was used to assess the sequential effect of the SDH on the scores of the Short Form-12 among people living with HIV.

    Results

    Results show that many psychosocial, medical, demographic, financial, and vocational factors are significant predictors of HRQOL.

    Conclusions

    Gaining a deeper understanding of the impact of SDH on HRQOL is critical for rehabilitation counselors to develop effective assessments and interventions.

    Source:
    Rehabilitation Research, Policy, and Education
  • The Participation of Cognitively Impaired Elderly in ResearchGo to article: The Participation of Cognitively Impaired Elderly in Research

    The Participation of Cognitively Impaired Elderly in Research

    Article

    It is critical that cognitively impaired adults be permitted to participate in research in order to develop a greater understanding of the underlying causes of the impairments and strategies to prevent or ameliorate their impact. Significant ethical and legal issues may arise in the recruitment and enrollment of these persons as study participants, due to difficulties in understanding information, uncertainty regarding the existence of sufficient mental capacity to provide informed consent to participate, and the potential for coercion to participate as a function of limited capacity and dependence on others for care. This article explores these issues and suggests mechanisms to maximize the understanding of information and facilitate the cognitively impaired elders’ expression of choice during incapacity.

    Source:
    Care Management Journals
  • Measuring Case Managers’ Advance Care Planning Practice: Translating Focus Group Findings to Survey DevelopmentGo to article: Measuring Case Managers’ Advance Care Planning Practice: Translating Focus Group Findings to Survey Development

    Measuring Case Managers’ Advance Care Planning Practice: Translating Focus Group Findings to Survey Development

    Article

    Sequential mixed methods is a useful research design to inform second-stage methodology when investigating an area of practice in which relatively little is known. This article describes how focus group findings were used to measure advance care planning practice among community-based case managers. The initial qualitative study utilized focus groups to explore aspects of practice in this area. Data revealed themes that embodied ambiguous views of advance care planning, divergent roles in practice, a continuum of practice activities, and multiple facilitators and barriers to practice. In order to further examine case managers’ advance care planning practices, qualitative findings were used to develop the Case Managers Advance Care Planning Practices Instrument. Implications for qualitative to quantitative measurement are discussed.

    Source:
    Care Management Journals
  • Views on Aging: Domain-Specific Approaches and Implications for Developmental RegulationGo to article: Views on Aging: Domain-Specific Approaches and Implications for Developmental Regulation

    Views on Aging: Domain-Specific Approaches and Implications for Developmental Regulation

    Article

    Views on aging affect development across the life span through different pathways: They create a developmental context for older people by influencing behavior toward them (stereotyping, ageism), and they become incorporated into the self-concept of older people (self-stereotyping, internalization), which influences their attitudes toward their own age and aging, aging-related behaviors, life satisfaction, and even mortality. In this chapter, we argue that views on aging should be conceived as a domain-specific construct. We provide theoretical arguments for such a view that stems from life span research, as well as empirical evidence from studies that investigate the content and activation of views on aging as well as their consequences for developmental outcomes. We argue that a domainspecific perspective provides a fruitful and more comprehensive framework for addressing the role of views on aging in developmental regulation across the life span.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Aging and Drug TherapyGo to article: Aging and Drug Therapy

    Aging and Drug Therapy

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • In Memoriam: Philip W. Brickner, MDGo to article: In Memoriam: Philip W. Brickner, MD

    In Memoriam: Philip W. Brickner, MD

    Article
    Source:
    Care Management Journals
  • Taxes Well PaidGo to article: Taxes Well Paid

    Taxes Well Paid

    Article
    Source:
    Care Management Journals
  • Undermedication Among Geriatric Outpatients: Results of a Randomized Controlled TrialGo to article: Undermedication Among Geriatric Outpatients: Results of a Randomized Controlled Trial

    Undermedication Among Geriatric Outpatients: Results of a Randomized Controlled Trial

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Understanding the Mortality Decline at Older AgesGo to article: Understanding the Mortality Decline at Older Ages

    Understanding the Mortality Decline at Older Ages

    Article

    For over a century, western countries have shown continuing declines in mortality at increasingly older ages. The reasons for these mortality declines are poorly understood. For the Netherlands, this study examines to what extent the mortality decline at old age can be explained by improved life course characteristics of subsequent cohorts (life course factors) and/or by improved medical and longterm care (period factors).

    Source:
    Annual Review of Gerontology and Geriatrics
  • Diagnosis and Treatment of Urinary IncontinenceGo to article: Diagnosis and Treatment of Urinary Incontinence

    Diagnosis and Treatment of Urinary Incontinence

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Hospice and Palliative Care: Questions and AnswersGo to article: Hospice and Palliative Care: Questions and Answers

    Hospice and Palliative Care: Questions and Answers

    Article
    Source:
    Care Management Journals
  • Older People and Their FamiliesGo to article: Older People and Their Families

    Older People and Their Families

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Loss, Trauma, and Resilience in AdulthoodGo to article: Loss, Trauma, and Resilience in Adulthood

    Loss, Trauma, and Resilience in Adulthood

    Article

    The first wave of research on loss and potentially traumatic events (PTEs) was dominated by either a psychopathological approach emphasizing individual dysfunction or an event approach emphasizing average differences between exposed and nonexposed groups. We consider the strengths and limitations of these approaches and then review more recent research that has focused on the heterogeneity of outcomes following aversive events. Using both traditional analytic tools and sophisticated latent trajectory modeling, this research has identifi ed a set of prototypical outcome patterns. Typically, the most common outcome following PTEs is a stable trajectory of healthy functioning or resilience. We review research showing that resilience is not the result of a few dominant factors, but rather that there are multiple independent predictors of resilient outcomes, and then review some of the possible factors that might inform resilient outcomes in older populations. Finally, we close by critically evaluating recent efforts to inculcate resilience and suggest possible ways such efforts might best move forward.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Pharmacist Interventions in Residential Care FacilitiesGo to article: Pharmacist Interventions in Residential Care Facilities

    Pharmacist Interventions in Residential Care Facilities

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Increased Longevity in HIV: Caring for Older HIV-Infected AdultsGo to article: Increased Longevity in HIV: Caring for Older HIV-Infected Adults

    Increased Longevity in HIV: Caring for Older HIV-Infected Adults

    Article
    Source:
    Care Management Journals
  • Nature, Nurture, and Chance: Their Roles in Interspecific and Intraspecific Modulations of AgingGo to article: Nature, Nurture, and Chance: Their Roles in Interspecific and Intraspecific Modulations of Aging

    Nature, Nurture, and Chance: Their Roles in Interspecific and Intraspecific Modulations of Aging

    Article

    The constitutional genome, its environment, and a range of stochastic events all interact to produce virtually unique patterns of lifespan and health span. This is certainly the case for genetically heterogeneous organisms living in the wild, but there is growing evidence of considerable variations even among inbred organisms maintained in the laboratory. When one compares different species, it is clear that the dominant variable is the constitutional genome. I shall argue, however, that stochastic events are the dominant variables among members of the same species. Somatic mutations clearly play important roles. Leslie Orgel's protein synthesis error catastrophe remains a potential mechanism because it has been insufficiently tested in vivo. The recent discovery of widespread random clonal monoallelic expression in the laboratory of Andrew Chess provides yet another layer of complexity. Perhaps the most cogent explanation of the growing phenotypic variations among aging cohorts, however, are increasing drifts in gene expression with age, presumably epigenetic in origin, but conceivably also driven by posttranscriptional mechanisms. I shall argue that such drifts evolved because they proved adaptive to groups of organisms in unpredictable environments, but that age-related expansions of such variegated gene expressions will have escaped the force of natural selection and are responsible for a wide range of quasi-stochastic geriatric pathologies, both proliferative and degenerative.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Benefits of Physical Activity on Cognitive Functioning in Older AdultsGo to article: Benefits of Physical Activity on Cognitive Functioning in Older Adults

    Benefits of Physical Activity on Cognitive Functioning in Older Adults

    Article

    As the world becomes more populated and more medically advanced, more people are starting to live longer. There are growing concerns for the health and well-being of an ever-growing population. Aging is accompanied by a series of changes, cognitive decline being one of them. As health becomes more challenging, physical activity may become more cumbersome. However, in many instances, physical activity has been found to prevent and delay cognitive decline. In fact, exercise may prove to be a powerful preventative measure against cognitive impairment in older adults. The aim of this chapter is to explore the evidence base of the effects of physical activity on cognitive decline prevention as well as to review the recommended guidelines for physical activity in this population based on findings in the field.

    Source:
    Annual Review of Gerontology and Geriatrics
  • The Use of the Minimum Data Set: Home Care in a Case Management Project in Hong KongGo to article: The Use of the Minimum Data Set: Home Care in a Case Management Project in Hong Kong

    The Use of the Minimum Data Set: Home Care in a Case Management Project in Hong Kong

    Article

    130 hospital-discharged elderly patients received our comprehensive assessment by using a Chinese Minimum Data Set-Home Care (MDS-HC). Our case manager developed and implemented care plans with reference to the computer-generated Clients Assessment Protocols. Results showed that the MDS-HC was sensitive to identify elderly persons’ holistic needs, and helpful in formulating all-inclusive care plans.

    Source:
    Care Management Journals
  • Recovering From the Suicide of a Client With Schizophrenia: Recommendations for Case ManagersGo to article: Recovering From the Suicide of a Client With Schizophrenia: Recommendations for Case Managers

    Recovering From the Suicide of a Client With Schizophrenia: Recommendations for Case Managers

    Article

    Many case managers in mental health settings occasionally experience a client’s suicide, and this can be an emotionally devastating event. The symptoms of schizophrenia, including the difficulties those client face in forming trusting relationships with others, brings special challenges to the case manager’s recovery because of the efforts put into developing that relationship. The purposes of this article are to describe a range of possible reactions of case managers following the suicide of a client with schizophrenia and how those persons can be helped to make a positive recovery from such an event. A summary of suicide risk factors for case managers to assess when working with clients who have schizophrenia is included.

    Source:
    Care Management Journals
  • Book ReviewsGo to article: Book Reviews

    Book Reviews

    Article
    Source:
    Care Management Journals
  • Elusiveness of Family Life: A Challenge for the Sociology of AgingGo to article: Elusiveness of Family Life: A Challenge for the Sociology of Aging

    Elusiveness of Family Life: A Challenge for the Sociology of Aging

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • The Cash and Counseling Demonstration and Evaluation: Focus Groups Inform Design of a Consumer-Directed Cash OptionGo to article: The Cash and Counseling Demonstration and Evaluation: Focus Groups Inform Design of a Consumer-Directed Cash Option

    The Cash and Counseling Demonstration and Evaluation: Focus Groups Inform Design of a Consumer-Directed Cash Option

    Article

    The purposes of the study were to explore consumer preferences for a cash option, to inform the ongoing CCDE survey and program design, and to identify the messages that the CCDE and other states should include when informing consumers about a cash option. The preference study consisted of 3 parts: 11 presurvey focus groups, a telephone survey in each of the 4 participating states, and 16 post-survey focus groups. This article highlights unique results from pre- and post-survey focus groups. Focus group discussions were audiotaped and videotaped and transcribed. Transcripts were manually coded and text was clustered according to the moderator’s guide questions and some new and recurrent themes that emerged. Overall, focus group participants, including elders, expressed positive feelings about the CCDE, especially about having a role in hiring workers and determining the workers’ schedules and responsibilities. Focus groups provided important lessons about features to highlight when presenting program information to potential consumers and their families. Program planners must also bear in mind consumer concerns, especially considering that less than 10% of eligible Medicaid consumers volunteered for the cash option. These findings will be useful in guiding other states as they develop new cash and counseling programs, especially those in the current Cash and Counseling replication project.

    Source:
    Care Management Journals
  • The Construct of Control: Biological and Psychosocial CorrelatesGo to article: The Construct of Control: Biological and Psychosocial Correlates

    The Construct of Control: Biological and Psychosocial Correlates

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Nutrition and AgingGo to article: Nutrition and Aging

    Nutrition and Aging

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Pathways Toward the Third Age: Studying a Cohort From the ‘Golden Age’Go to article: Pathways Toward the Third Age: Studying a Cohort From the ‘Golden Age’

    Pathways Toward the Third Age: Studying a Cohort From the ‘Golden Age’

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Retirement: A Dance to the Music of TimeGo to article: Retirement: A Dance to the Music of Time

    Retirement: A Dance to the Music of Time

    Article
    Source:
    Care Management Journals
  • Behavioral Interventions and Motivational Systems in the Nursing HomeGo to article: Behavioral Interventions and Motivational Systems in the Nursing Home

    Behavioral Interventions and Motivational Systems in the Nursing Home

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • The Role of Physical and Occupational Therapies in Fall Prevention and Management in the Home SettingGo to article: The Role of Physical and Occupational Therapies in Fall Prevention and Management in the Home Setting

    The Role of Physical and Occupational Therapies in Fall Prevention and Management in the Home Setting

    Article
    Source:
    Care Management Journals
  • Providing Health and Social Services to Older LGBT AdultsGo to article: Providing Health and Social Services to Older LGBT Adults

    Providing Health and Social Services to Older LGBT Adults

    Article

    Little is known about the home care context for lesbian, gay, bisexual, and transgender (LGBT) older adults, most of whom, like the general older adult population, prefer to stay in their home and community for as long as possible. The very limited LGBT-focused home care literature available suggests that there are unique concerns about providing care in the home. In this chapter, access to affi rmative home care services for LGBT older adults is located within the context of the LGBT health services access research literature. A program of research focused on identifying key access and equity indicators and associated prompts to assist organizations to provide high-quality, affi rmative home care for these populations is described.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Intergenerational Transfers: Economic, Demographic, and Social PerspectivesGo to article: Intergenerational Transfers: Economic, Demographic, and Social Perspectives

    Intergenerational Transfers: Economic, Demographic, and Social Perspectives

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • The Medicare Home Health Benefit Implications of Recent Payment ChangesGo to article: The Medicare Home Health Benefit Implications of Recent Payment Changes

    The Medicare Home Health Benefit Implications of Recent Payment Changes

    Article

    The interim payment system (IPS) for Medicare home health services, enacted in the Balanced Budget Act of 1997, was intended to slow the growth of home health expenses until HCFA could design a new prospective system. Instead, the IPS has acted like a per-case payment system without case-mix adjustment. Its impact on agencies, along with other policy pressures, has been first to slow and then to reverse the dramatic expansion of the home health sector. In this paper, we identify the impetus for payment changes in the recent history of the Medicare home health benefit. We then present emerging evidence about the effects of IPS and other recent policies on home health. Finally, we draw several lessons from this experience for the impending prospective payment system.

    Source:
    Care Management Journals
  • Cross National Disparities and DisabilitiesGo to article: Cross National Disparities and Disabilities

    Cross National Disparities and Disabilities

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • PrefaceGo to article: Preface

    Preface

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Assessment of Behavioral Disturbance in Older AdultsGo to article: Assessment of Behavioral Disturbance in Older Adults

    Assessment of Behavioral Disturbance in Older Adults

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Development of a Case Management Quality QuestionnaireGo to article: Development of a Case Management Quality Questionnaire

    Development of a Case Management Quality Questionnaire

    Article

    This study documents the development of a new tool to measure the quality of community case management for elderly clients. Information obtained from literature review, client focus groups, and pilot surveys with clients served as the basis for the development of a Case Management Quality Questionnaire (CMQQ). This measure, along with satisfaction, health status, and demographic questions, was administered to 174 home care clients and 78 family members of long term care residents for evaluation of case management services that clients had received in the last 2 to 6 months. Principal components analysis with oblique (Oblimin) rotation identified three subscales of the CMQQ: (1) accessibility, (2) efficiency, and (3) assessment/coordination skill. Study findings suggest that the CMQQ is reliable, valid, and of value in understanding satisfaction with case coordination. Based on client feedback and analysis of the results, some future modifications to the measure are worthy of study. Others interested in measuring and improving case management may similarly benefit from the use of the CMQQ.

    Source:
    Care Management Journals
  • An Overview of In-Home Care for Older People in Portugal: An Empirical Study About the CustomersGo to article: An Overview of In-Home Care for Older People in Portugal: An Empirical Study About the Customers

    An Overview of In-Home Care for Older People in Portugal: An Empirical Study About the Customers

    Article

    Background: The Portuguese in-home care services have never been adequately studied or identified. This is because of the lack of classification of variables related to the care receiver and to the demographic and organizational context in which it is inserted.

    Methods: The 126 organizations in the central region of Portugal were categorized into four groups depending on whether they were located in a rural or urban environment and on whether they were large or small organizations. To obtain information, the In-Home Care Protocol (ProSAD), Elderly Assessment System (EASYcare), and the Center for Epidemiologic Studies–Depression (CES-D) scale were applied to 48 customers (6 randomly chosen customers of in-home care services of each of the 8 randomly selected organizations, 2 per group of variables).

    Results: The rural context denoted a lack of diversity of services and the number of organizations available is reduced, which implies less time spent with the customers. The more dependent customers at the time of registration (Kruskal–Wallis test [KW] = 12.79; p < .05) in large organizations (Mann–Whitney [U] = 190.5; p < .05) benefit more from the services. Conclusions: In-home care services are underused and are oriented to treat those that have a family caregiver. Overall, in-home care in Portugal still has much to achieve when compared with other European countries.

    Source:
    Care Management Journals
  • Remember?Go to article: Remember?

    Remember?

    Article
    Source:
    Care Management Journals
  • EditorialGo to article: Editorial

    Editorial

    Article
    Source:
    Care Management Journals
  • Transnational Caregiving: Part 1, Caring for Family Relations Across NationsGo to article: Transnational Caregiving: Part 1, Caring for Family Relations Across Nations

    Transnational Caregiving: Part 1, Caring for Family Relations Across Nations

    Article

    This article concerns how globalization and the aging of the world’s population are affecting the already complex issue of intergenerational transnational caregiving. Globalization has caused an increase in workforce mobility with large numbers of individuals seeking employment overseas. This, coupled with increased longevity globally, has resulted in many workers leaving their elderly parents in need of care in their home countries. This has spawned caregiving across national borders, or caring for family relations across nations. Currently in the United States, not enough emphasis is given to family caregiving. Data compiled by AARP and the National Alliance for Caregiving estimate the economic value for this group of family caregivers in 2007 to be $375 billion, accounting for 34–52 million family caregivers per given year. This does not include those families who are transnational caregivers. The seminal work in this emerging field has been done by social anthropologists Loretta Baldassar, Cora Velekoop Baldock, and Raelene Wilding, who have defined the components of transnational caregiving based on an ethnographic study using qualitative data to study nine immigrant communities in Western Australia. Although their research focused on caregiving from a distance, additional work has been added to the discussion by introducing the element of “care drain” and further cultural perspectives. Therefore, this research is an exploratory study on intergenerational transnational caregiving within the context of the changing world and its demographics. Within the context of globalization and global aging, the following questions are addressed: What is the significance of family caregiving? What is a transnational? How has technology changed “transnationalism” today? What are the elements that comprise transnational caregiving? How does culture play a role in transnational caregiving? What are some of the national initiatives undertaken by governments to aid in workforce issues and recognition of caregiving organizations? By exploring these questions, it is hoped that there will be a better understanding of transnational caregiving and its relevance in all societies.

    Source:
    Care Management Journals
  • Altering the Home Care Agency/Client Relationship: Notice RequirementsGo to article: Altering the Home Care Agency/Client Relationship: Notice Requirements

    Altering the Home Care Agency/Client Relationship: Notice Requirements

    Article

    Many older and disabled individuals regularly receive valuable services from home health agencies (HHAs). The unilateral termination or reduction of such services by an HHA may exert a significant impact on the life of a client who has come to depend on those services. The prerogatives of Medicare-certified HHAs to terminate their relationships with clients are constrained today not only by contract and tort law principles, but also by federal statutes and regulations establishing Conditions of Participation, including provisions concerning clients’ rights. A recent important federal judicial decision interpreted and expanded the legal responsibilities of HHAs to provide formal notice to their Medicare clients before terminating or reducing home health care services to those clients, regardless of the reason for ending or altering the relationship. This article critically discusses the background, holding, and practice implications of the 2004 Lutwin v. Thomson decision, which imposes these notice requirements on HHAs.

    Source:
    Care Management Journals
  • Attitudes toward Old Age and Elderly PersonsGo to article: Attitudes toward Old Age and Elderly Persons

    Attitudes toward Old Age and Elderly Persons

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • The Social Context of Emotional ExperienceGo to article: The Social Context of Emotional Experience

    The Social Context of Emotional Experience

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Resilience Across the Life SpanGo to article: Resilience Across the Life Span

    Resilience Across the Life Span

    Article

    This chapter discusses the concept of resilience from a life span perspective informed by relational developmental systems theory. Resilience involves mutually beneficial (adaptive) relations between characteristics of individuals (e.g., their self-regulation behaviors) and features of the ecology (e.g., resources promoting healthy development); these links may be represented as individual ←→ context relations, and they involve adjustment in the context of challenges or maintenance of appropriate functioning in the face of variations in the resources needed to achieve health. Resilience, then, is an attribute of positive human development (PHD) achieved through adaptive individual ←→ context relations (termed adaptive “developmental regulations”). We review research across the life span that speaks to the use of this conception of resilience for understanding the contributions individuals make to their own positive development and to the maintenance or perpetuation of PHD-supportive assets of their ecologies. Directions for further research and for applications aimed at promoting PHD are discussed.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Old and on Their OwnGo to article: Old and on Their Own

    Old and on Their Own

    Article
    Source:
    Care Management Journals
  • Social Marketing Principles Enhance Enrollment in the Cash and Counseling Demonstration and EvaluationGo to article: Social Marketing Principles Enhance Enrollment in the Cash and Counseling Demonstration and Evaluation

    Social Marketing Principles Enhance Enrollment in the Cash and Counseling Demonstration and Evaluation

    Article

    Purpose of the study: Using focus group data, this article discusses the use of social marketing principles to enhance enrollment in the Cash and Counseling Demonstration and Evaluation (CCDE). Design and methods: Focus groups were conducted in person and by conference call in two CCDE states, Arkansas and Florida. In Florida, Department of Elder Affairs and Developmental Services Program (DS) staff participated in seven focus groups. In Arkansas, four focus groups were conducted with professionals likely to come into contact with Medicaid consumers who are eligible for Arkansas’ cash option program. Focus group transcripts were coded according to the project research questions. Results: Several important lessons emerged including the importance of (a) conducting process evaluation activities, such as the social marketing focus groups, early during program implementation; (b) using multiple approaches and contacts to inform potential consumers and their families about a new, complex program; (c) carefully selecting and training personnel to conduct outreach and enrollment activities; and (d) developing specific messages to include in marketing the cash option. Implications: Using social marketing principles to examine CCDE enrollment has provided important information to enhance this program.

    Source:
    Care Management Journals
  • Still Dying After All These Years: A Classical Library for Contemporary ControversiesGo to article: Still Dying After All These Years: A Classical Library for Contemporary Controversies

    Still Dying After All These Years: A Classical Library for Contemporary Controversies

    Article

    A review and discussion of Death, Dying and the Ending of Life, edited by Margaret P. Battin, Leslie P. Francis, and Bruce M. Landesman. Ashgate Publishing, 2007. The many philosophical, ethical, legal, and social aspects of death and the dying process remain deeply controversial despite substantial and continuous public discussion and debate about them. Springing from an in-depth review of a newly-published compilation of some of the most seminal writings in this area, the author in this essay reflects on and systematically analyzes how the classical literature of the past millennium has set the intellectual stage and in many respects established the rules of engagement for modern discourse on end-of-life decisions and decision-making.

    Source:
    Care Management Journals
  • Irony and the Sociocultural Construction of Old Age in South Korea: Perspectives From Government, the Medical Profession, and the AgedGo to article: Irony and the Sociocultural Construction of Old Age in South Korea: Perspectives From Government, the Medical Profession, and the Aged

    Irony and the Sociocultural Construction of Old Age in South Korea: Perspectives From Government, the Medical Profession, and the Aged

    Article

    This article explores the intersection between discourses with multiple meanings that relate to the cultural construction of elder identities in South Korea. The authors explore the experiences of elder patients at a free clinic to consider how government policy, attitudes among biomedical professionals, and elders themselves come into contact and influence the experiences of older Koreans within the national health care system. The study is ethnographic, using interview data to examine how the identities of elder Koreans are being shifted from “weak and in need of care” to “potentially problematic consumer” and how governmental policies both stimulate and respond to that shift. By focusing on the situational status of the elderly, this article is intended to represent the voices of some elderly, voices that can be submerged within the process of decision making related to public policy.

    Source:
    Care Management Journals
  • Social Role Theory and Social Role Valorization for Care Management PracticeGo to article: Social Role Theory and Social Role Valorization for Care Management Practice

    Social Role Theory and Social Role Valorization for Care Management Practice

    Article

    This article proposes that social role theory (SRT) and social role valorization (SRV) be established as organizing theories for care managers. SRT is a recognized sociological theory that has a distinctive place in care management practice. SRV is an adjunct for SRT that focuses on people who are devalued by being in a negative social position and supports behavior change and movement to a valued social position.

    Source:
    Care Management Journals
  • Creating the Strategic Future of Long-Term-Care OrganizationsGo to article: Creating the Strategic Future of Long-Term-Care Organizations

    Creating the Strategic Future of Long-Term-Care Organizations

    Article

    The operating environment in the health care industry is turbulent—organizations are expected to adapt or die. This paper addresses the structure of a strategic planning process for long-term-care organizations. Nursing homes, assisted living (personal care) facilities, continuing care retirement communities, adult day services centers, hospice programs and home-and community-based agencies face both opportunities and threats. The authors recommend an eight-step process for strategy making: plan to plan; external analysis; internal analysis; vision; matching current and future strategies; strategy choice; action and linkage to operations and budget. A case example illustrates the concepts. Long-term-care leaders are encouraged to plan for their future or face a future planned by competitors and regulators.

    Source:
    Care Management Journals
  • Case Management: Who Needs it? Does it Work?Go to article: Case Management: Who Needs it? Does it Work?

    Case Management: Who Needs it? Does it Work?

    Article

    Even after 30 years of experience, two questions persist about case management practice. Who needs it and does it work? Answers to these questions are neither direct nor simple. This article examines the significance of various contexts (policy, system, community, and organization) to efforts attempting to provide responses to these basic questions. Beyond the question of who needs case management, two additional questions are addressed. Who needs it and who gets it? Clients’ qualitative perspectives on case management effectiveness, beyond attempts to measure satisfaction and quality of life, are usually absent. The article concludes with a discussion of whether these are the right questions.

    Source:
    Care Management Journals
  • Stage Presence—Body Presence: Movement and Body Experience With the ElderlyGo to article: Stage Presence—Body Presence: Movement and Body Experience With the Elderly

    Stage Presence—Body Presence: Movement and Body Experience With the Elderly

    Article
    Source:
    Care Management Journals
  • The Impact of Poverty on Older PersonsGo to article: The Impact of Poverty on Older Persons

    The Impact of Poverty on Older Persons

    Article
    Source:
    Care Management Journals
  • Living Independently Is Good: Residence Patterns in Rural North China ReconsideredGo to article: Living Independently Is Good: Residence Patterns in Rural North China Reconsidered

    Living Independently Is Good: Residence Patterns in Rural North China Reconsidered

    Article

    Filial piety provides an important ideological basis for family-based support in China. Evidence indicates that in recent years the support of the aged within the Chinese extended family has decreased. This article examines filial piety, residence, and support arrangements in three rural Chinese villages. Anthropologists independently conducted research in these villages in the 1990s: Hong Zhang in Zhongshan Village in Hubei Province, Yunxiang Yan in Xiajia Village in Heilongjiang Province, and myself in Lijia Village in Shandong Province. This article examines the strategies used by the young and old in negotiating intergenerational support and residential arrangements within the context of local village circumstances and policies. In each village, the aged are increasingly likely to live apart from children, and to express a preference for living independently. Although these facts appear to contradict filial piety, filial piety continues to be valued. Filial respect of elders, however, is seen less as an inherent right and more as a reciprocal relationship that can be built, maintained, and lost. Housing policies and the economic status of the aged both appear to play an important role in explaining the common trends in these villages as well as explaining the differences between them. To varying degrees in each village, power has shifted to the younger generation.

    Source:
    Care Management Journals
  • Expanding the Consumer-Directed Workforce by Attracting and Retaining Unaffiliated WorkersGo to article: Expanding the Consumer-Directed Workforce by Attracting and Retaining Unaffiliated Workers

    Expanding the Consumer-Directed Workforce by Attracting and Retaining Unaffiliated Workers

    Article

    Unaffiliated workers are directly hired personal assistance workers who are not employed through an agency and are not family members or close friends. This article examines the working conditions of unaffiliated workers in a consumer-directed setting in comparison to agency workers and to other consumer-directed workers. Unaffiliated workers earned higher wages than their peers but were less satisfied with these wages and benefits than other directly hired workers. Findings for consumer-directed programs are discussed in terms of the recruitment and retention of unaffiliated workers, implications for consumers and workers, and future research recommendations.

    Source:
    Care Management Journals
  • A Population Study of Alzheimer’s Disease: Findings From the Cache County Study on Memory, Health, and AgingGo to article: A Population Study of Alzheimer’s Disease: Findings From the Cache County Study on Memory, Health, and Aging

    A Population Study of Alzheimer’s Disease: Findings From the Cache County Study on Memory, Health, and Aging

    Article

    There are several population-based studies of aging, memory, and dementia being conducted worldwide. Of these, the Cache County Study on Memory, Health and Aging is noteworthy for its large number of “oldest-old” members. This study, which has been following an initial cohort of 5,092 seniors since 1995, has reported among its major findings the role of the Apolipoprotein E gene on modifying the risk for Alzheimer’s disease (AD) in males and females and identifying pharmacologic compounds that may act to reduce AD risk. This article summarizes the major findings of the Cache County study to date, describes ongoing investigations, and reports preliminary analyses on the outcome of the oldest-old in this population, the subgroup of participants who were over age 84 at the study’s inception.

    Source:
    Care Management Journals
  • Emotion and Control: A Life-Span PerspectiveGo to article: Emotion and Control: A Life-Span Perspective

    Emotion and Control: A Life-Span Perspective

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Psychotropic Drug Use in Home Health Care: Problems and Directions for ResearchGo to article: Psychotropic Drug Use in Home Health Care: Problems and Directions for Research

    Psychotropic Drug Use in Home Health Care: Problems and Directions for Research

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Ethical Decision Making Within the Bureaucratic Context: A Case StudyGo to article: Ethical Decision Making Within the Bureaucratic Context: A Case Study

    Ethical Decision Making Within the Bureaucratic Context: A Case Study

    Article

    Balancing the polarized notions of quality and quantity of service and care is a challenge for the 21st century health and social service system. The expectation of transparent decision making at both the policy and the practice level of case management has forced practitioners to seek guidance in ethical decision making. Case management, as a system, has potential to lead this new practice approach by incorporating the principles of ethical decision making in planning and coordinating care. A recent case study of ethical decision making within the bureaucratic context offers some insight and learning and may help inform future practice.

    Source:
    Care Management Journals
  • Environmental Gerontology Research and Practice: The Challenge of ApplicationGo to article: Environmental Gerontology Research and Practice: The Challenge of Application

    Environmental Gerontology Research and Practice: The Challenge of Application

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Tube Feeding in Advanced Dementia: An Exploratory Survey of Physician KnowledgeGo to article: Tube Feeding in Advanced Dementia: An Exploratory Survey of Physician Knowledge

    Tube Feeding in Advanced Dementia: An Exploratory Survey of Physician Knowledge

    Article

    The administration of artificial nutrition by means of a percutaneous endoscopic gastrostomy (PEG) tube in older persons in the advanced stages of dementia is commonplace, yet the treatment is associated with significant treatment burdens and unclear benefits in this population. In addition, there is wide and unexplained geographic variability in the use of PEG in advanced dementia, which may stem partly from physicians’ lack of understanding about its indications, risks, benefits, and effect on quality of life in advanced dementia. This study was a mail survey undertaken to assess physician knowledge regarding tube feeding in advanced dementia and explore whether certification in geriatrics or other physician characteristics are associated with physician knowledge. To assess knowledge about tube feeding, we asked participants to rate the importance of commonly cited, but non–evidence based, indications for tube feeding in advanced dementia, including recurrent aspiration pneumonia, abnormal swallowing evaluations, abnormal nutritional parameters, preventing an uncomfortable death, and others. Discrepancies between physician knowledge and current evidence regarding tube feeding in advanced dementia were found, indicating a need for improved education of primary care physicians in order to ultimately provide better end-of-life care for patients with advanced dementia.

    Source:
    Care Management Journals
  • Book ReviewsGo to article: Book Reviews

    Book Reviews

    Article
    Source:
    Care Management Journals
  • The Socioeconomic Gradient in Healthy Life ExpectancyGo to article: The Socioeconomic Gradient in Healthy Life Expectancy

    The Socioeconomic Gradient in Healthy Life Expectancy

    Article

    Healthy life expectancy is the length of expected life lived in a healthy state; remaining life would be unhealthy life. When health is defined by ability and disability, the measure is usually referred to as active and inactive life. Those with higher socioeconomic status can expect to live more healthy years and fewer unhealthy years; as a consequence of this, socioeconomic differences in healthy life expectancy tend to be greater than differences in total life expectancy. At age 70, there is a 1 year difference in total life expectancy for men with a high school degree versus those with less education; however, there is a 1.5 year difference in years lived without disability. For women, the difference is 2.2 years of expected life with some disability versus 1.5 years difference in total life expectancy.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Frankly, None of Us Know What Dementia Is: Dementia Caregiving Among Iranian Immigrants Living in SwedenGo to article: Frankly, None of Us Know What Dementia Is: Dementia Caregiving Among Iranian Immigrants Living in Sweden

    Frankly, None of Us Know What Dementia Is: Dementia Caregiving Among Iranian Immigrants Living in Sweden

    Article

    In quite a short amount of time, Sweden has gone from being a relatively homogeneous society to a multicultural one, with a rapid expansion of immigrants having culturally and linguistically diverse (CALD) backgrounds growing old in Sweden. This is particularly interesting in relation to studying age-related dementia diseases. Research shows that not only do CALD persons with dementia diseases tend to mix languages, have difficulties with separation of languages, or revert to speaking only their native tongue as the disease progresses, but they also show tendencies to experience that they live in the cultural environment in which they were brought up, rather than in the current Swedish one. In this article, we explore findings in relation to one such CALD group in Sweden, Iranians. The article is empirically driven and based on data gathered in 2 separate settings with specific ethnocultural profiles, offering dementia care with Middle Eastern, Arab, and/or Persian profile. Observations were carried out in combination with semistructured in-depth interviews (n = 66). By using a combination of content and ethnographic analysis, 4 main findings related to ethnocultural dementia care were elucidated. These include (a) a wider recognition of people from different CALD backgrounds possibly having different perceptions of what dementia is, (b) a possibility that such ascribed meaning of dementia has a bearing on health maintenance and health-seeking behavior as well as the inclination to use formal services or not, (c) choosing to use formal service in the forms of ethnoculturally profiled dementia care facility seems to relate to being able to “live up to ideals of Iranian culture,” and (d) “culture,” however ambiguous and hotly debated a concept it is, appears to be a relevant aspect of people’s lives, an aspect that is both acquired as well as ascribed to oneself and to others. As such, we argue that culture needs to be further addressed in relation to dementia care in multicultural societies because ascribing culture boxes people in as well as out. In addition, ethnocultural contextualization of dementia care needs to be understood in relation to this because it affects the care provided.

    Source:
    Care Management Journals
  • Patient-Centered Mental Health Care: Encouraging Caregiver ParticipationGo to article: Patient-Centered Mental Health Care: Encouraging Caregiver Participation

    Patient-Centered Mental Health Care: Encouraging Caregiver Participation

    Article

    Caregivers of patients with mental illness play a vital role caring for their loved ones, yet they may not always be fully included in the process of assessment and treatment. A patient-centered approach to treating persons with mental illness views caregivers as partners in providing care for the patient. This study sought to explore perceptions of caregivers of persons with mental illness regarding the care their loved ones receive and to illicit specific issues caregivers wish to communicate with professionals that could improve patient care. A modified nominal group technique exercise was conducted as part of a suicide prevention workshop. Participants completed a four-item questionnaire. Five main themes emerged: the caregivers’ perception that they need to be included in the mental health care of their loved one; concerns about the diagnosing process; communication with professionals; a desire for individualized, holistic treatment; and the need for information about services and resources for the caregiver and the patient. Findings are similar to studies that also sought to understand the perspectives of caregivers. Caregivers provide an invaluable resource for the patient with mental illness. Efforts to include caregivers would enhance the overall care provided to patients with mental illness.

    Source:
    Care Management Journals
  • Families and Support Systems of LGBT EldersGo to article: Families and Support Systems of LGBT Elders

    Families and Support Systems of LGBT Elders

    Article

    Families and social support systems have been found to be instrumental for the physical and psychological well-being of older adults. However, the majority of research on families has assumed that all members within a family are hetero sexual. This chapter discusses families and social support systems for lesbian, gay, bisexual, and transgender (LGBT) older adults. The chapter initially provides an overview of the research on social networks and social support systems of the general older adult population. The discussion on LGBT older adults' families and social support systems highlights families of choice, LGBT communities, and the impact of disclosing one's sexual orientation on social network relationships. The chapter concludes with recommendations for future research and best practices that focus on addressing the unique needs and concerns of LGBT elders.

    Source:
    Annual Review of Gerontology and Geriatrics
  • PrefaceGo to article: Preface

    Preface

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Social Isolation, Loneliness, and Physical and Mental Health Among Black Older AdultsGo to article: Social Isolation, Loneliness, and Physical and Mental Health Among Black Older Adults

    Social Isolation, Loneliness, and Physical and Mental Health Among Black Older Adults

    Article

    Social isolation and loneliness are consistently associated with worse health and well-being outcomes among older adults. However, many studies have not examined their concurrent impact on health and well-being, and even fewer studies examine their influence among Black older adults. The 2014 and 2016 waves of the Health and Retirement Study were used to examine the influence of social isolation and loneliness among a nationally representative sample of Black older adults. Social isolation was measured using a social network index based on marital and household status, contact with family members and friends, and participation in social and religious activities. Loneliness was measured by the 3-item loneliness scale. Health outcomes were self-rated physical health and number of chronic health conditions, depressive symptoms, and lifetime occurrence of a psychiatric disorder. Each health outcome was examined using: (a) social isolation, (b) loneliness, and (c) social isolation and loneliness, controlling for sociodemographic covariates. Social isolation was associated with self-rated health and depressive symptoms, while loneliness was associated with all health outcomes. When examined jointly, social isolation was associated with self-rated health, while loneliness was associated with all health outcomes. Study findings suggest that due to its association with multiple physical and mental health measures, loneliness may be a more significant factor for health that should be routinely assessed in working with Black older adults.

    Source:
    Annual Review of Gerontology and Geriatrics
  • ECT for Geriatric Depression and Future TrendsGo to article: ECT for Geriatric Depression and Future Trends

    ECT for Geriatric Depression and Future Trends

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Hospice and Its Role in Improving End-of-Life CareGo to article: Hospice and Its Role in Improving End-of-Life Care

    Hospice and Its Role in Improving End-of-Life Care

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • The Importance of Planning for the FutureGo to article: The Importance of Planning for the Future

    The Importance of Planning for the Future

    Article

    This article explains various mechanisms that are available to plan for the future prior to the development of incapacity. These include powers of attorney, revocable living trusts, advance medical directives such as powers of attorney for health care and living wills, psychiatric advance directives, and guardianships and conservatorships. Case examples are utilized to illustrate the consequences of a failure to plan and what can be accomplished through advance planning. The suitability of each such mechanism is dependent on the situation of each individual. Additionally, the specific details of each mechanism may vary across states.

    Source:
    Care Management Journals
  • NYC Department for the Aging Annual Plan Summary: April 1, 2013–March 31, 2014Go to article: NYC Department for the Aging Annual Plan Summary: April 1, 2013–March 31, 2014

    NYC Department for the Aging Annual Plan Summary: April 1, 2013–March 31, 2014

    Article
    Source:
    Care Management Journals
  • Malleability of Human AgingGo to article: Malleability of Human Aging

    Malleability of Human Aging

    Article

    Steady growth in human life expectancy has been a key feature of the last century, with projected further increases likely to have enormous impacts on societies worldwide. Despite the significance of these changes, our understanding of the factors shaping this trend is incomplete. During most of the historical increase, by far, the major influence was progressive decline in early and midlife death rates because of the reduction in premature deaths, caused chiefly by infection. Recent decades have seen the emergence of a new driver of increasing longevity—declining mortality among those who are old already, pointing to greater malleability in human aging than had been foreseen. There is still debate, however, as to how much of this decrease in old age mortality is caused by a better early-life environment and how much is caused by improved conditions in late life. A unique resource exists in the case of Japan, where material circumstances for the general population were consistently adverse through the early decades of the 20th century but improved rapidly after 1950. Here, we compare the Japanese birth cohorts of 1900, 1910, and 1920 and follow their period and cohort mortality trends. The results show that cohorts with similar environments early in life have very different mortality trajectories in old age. This strengthens the expectation that preventive measures in later life can deliver great benefit, while not contradicting the importance of life course approaches, to improving health and well-being.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Families, Aging, and Social Change: Seven Agendas for 21st-Century ResearchersGo to article: Families, Aging, and Social Change: Seven Agendas for 21st-Century Researchers

    Families, Aging, and Social Change: Seven Agendas for 21st-Century Researchers

    Article
    Source:
    Annual Review of Gerontology and Geriatrics
  • Families in Later LifeGo to article: Families in Later Life

    Families in Later Life

    Article

    The implications of economic inequality for American families are profound, giving rise to widening race and socioeconomic disparities in key family transitions including marriage, divorce, cohabitation, childrearing, and family bereavement. However, little scholarly attention focuses on how these divergences in family structure shape the health and well-being of older adults, and especially older women. In this chapter, I propose that family relationships are an important although overlooked mechanism linking economic inequality to persistent race, socioeconomic, and gender disparities in late-life well-being. I provide a statistical snapshot of older adults’ families, showing how rates of marriage, divorce, widowhood, and remarriage differ markedly on the basis of gender, socioeconomic status, and race, with these disparities widening against the backdrop of rising economic inequality in the late 20th and early 21th centuries. I then describe how these patterns perpetuate disparities in late-life economic well-being, due in part to the structure of Social Security benefits which advantage those whose family lives conformed to the mid-20th century White middle-class “ideal” of a lifelong marriage between a male breadwinner and female homemaker. I further show how three stressful aspects of family lives—family bereavement, custodial grandparenting, and caregiving—disproportionately befall women, and especially low-income and women of color. As such, these family-related stressors exacerbate race, class, and gender-based disparities in health and well-being. I conclude by highlighting social policies that may help to mitigate against these disparities, and provide resources so that Americans of all backgrounds have an opportunity to grow old with dignity.

    Source:
    Annual Review of Gerontology and Geriatrics
  • Reflections on a Professional Journey to Making Home Life Better for Older Adults and FamiliesGo to article: Reflections on a Professional Journey to Making Home Life Better for Older Adults and Families

    Reflections on a Professional Journey to Making Home Life Better for Older Adults and Families

    Article

    In this essay, I assume the stance of a “reflective practitioner,” critically examining my research practices and trajectory to gain insight as to how I have engaged in and possibly impacted Environmental Gerontology. I first examine the “what” (description of what has been done), then examine the “so what” (factors contributing to success [or not] and key achievements), and finally, the “now what” (logical next steps or vision for future endeavors). I characterize my stance towards Environmental Gerontology as a consumer or “user” of its concepts and principles. My research focus is on employing key environmental constructs to develop and evaluate biopsychosocial environmental interventions to improve the “good life” or quality of life of older adults and family caregivers. I have considered the socio-physical environment from varied roles: as cause of behavioral or psychological outcomes; as moderator of outcomes, as mediator of outcomes, as an outcome itself, or as the context in which behavioral, cognitive, and affective processes unfold. I suggest that modifying physical and social environments results in clinically meaningful benefits to older adults and caregivers; and that understandings from Environmental Gerontology may advance the science of implementing interventions in real-world community, clinical, and service settings.

    Source:
    Annual Review of Gerontology and Geriatrics

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