Lived Experiences: An Examination of Older Adults\u27 Late-stage, Life-span Ecological Transition from a Home Residence to an Assisted Living Facility

The population of older adults in the United States is growing rapidly, and in response to demographic changes, a new housing market for elders known as assisted living is emerging as the fastest growing segment of the senior housing arena. While the impact of the transition to institutional facilities has been examined thoroughly in settings such as nursing homes, little is known about the influences of a late-life transition to assisted living (AL) on American elders. Using a phenomenologically oriented approach, this qualitative investigation examined the lived experiences of assisted living residents as a means of adding to the literature about the key developmental issues for elders and making recommendations for human services professionals who work with this population. The results of the investigation reflect fairly consistent findings about the reasons that elders move to assisted living. Health problems contribute much momentum to the transitioning process, as, it seems, do Western cultural values on individualism. The findings illuminated environmental concerns about social disconnectedness and a lack of challenging and meaningful activities within assisted living communities that have the potential to act as barriers to AL residents\u27 positive development. Another concern for elders who relocate to assisted living is the potential loss of autonomy when real and perceived opportunities for self-initiated decisions are not readily available to residents. The results also provided evidence that opportunities for personal enhancement, relationship development, and community service are possible for elders who live in assisted living. These factors, which contribute positively towards human growth and development in the late-life stage and which confront cultural stereotypes about older adults and the aging process as a period of decline, are bolstered when older adults are in autonomy-supportive environments, have opportunities to forge meaningful relationships, and engage their sense of competence

Care in my own home: Elders' accounts of receiving domiciliary care for the first time

Background: In England, over 700,000 people are supported to remain living in their own homes by receiving domiciliary care. The existing UK research focuses primarily on the quality and cost-effectiveness of care. Receiving care for the first time can be a significant change to daily life, yet there is a lack of research exploring elders’ experiences of first receiving domiciliary care. Aim: To explore elders’ accounts of receiving domiciliary care for the first time. Methodology: A critical realist approach was adopted. Individual semi-structured interviews took place with ten elders (aged 76-95) receiving domiciliary care in Southeast England. Interview transcripts were analysed using reflexive thematic analysis. Analysis: Two overarching themes were generated. The first overarching theme, ‘A new, important relationship’, comprises the themes: ‘Carers are like friends’ and ‘Support to continue with life’. The second overarching theme, ‘Who am I now? Changing view of oneself’, contains the themes: ‘Struggling to accept the need for help’ and ‘Lost parts of the self’. Conclusions: The findings suggest that receiving domiciliary care for the first time is a significant life event, which prompts realisation of one’s advancing age and a changing view of the self. A friendship-like relationship with carers promotes elders’ psychological well-being and supports elders to accept care into their lives. The findings highlight the considerable psychosocial value of domiciliary care. Potential implications include contributing to training for carers and health professionals supporting elders during the transition into receiving care

Towards a Resilient Future: Experiences with Community Managed Disaster Risk Reduction and Climate Change Adaptation

This testimony shows the urgency of the problems faced by people on the front line of climate change, which is exposing more and more people to increased risk of dis This testimony shows the urgency of the problems faced by people on the front line of climate change, which is exposing more and more people to increased risk of diaster and directly affecting their lives and livelihoods. Tragically, the global community turns a blind eye to the severity of the risks posed by climate change and is doing too little to help people prepare themselves for these risks. Community managed disaster risk reduction (CMDRR) is an effective strategy of addressing the impacts and effects of climate change and reducing communities' vulnerability to disasters

Policing alcohol and illicit drug use among Aboriginal and Torres Strait Islander people in metropolitan environments

Executive summary: This report presents the results of Australian Institute of Criminology research on issues and challenges of policing alcohol and illicit drug use among Aboriginal and Torres Strait Islander people in metropolitan environments. This report is a companion to the 2006 National Drug Law Enforcement Research Fund project The policing implications of cannabis, amphetamine and other illicit drug use in Aboriginal and Torres Strait Islander communities. The main purpose of both pieces of research was to contribute to police service knowledge of substance use by Indigenous people and to provide a framework for good practice policing of the issues associated with alcohol and drug misuse. Report structure The first section of this report provides a summary of available data on Indigenous alcohol and other drug (AOD) use in metropolitan areas. The second section reports on the challenges that police and other stakeholders identified through survey results and focus group/interview consultations that relate to policing Indigenous substance use in metropolitan areas. The final section of the report presents a suggested framework for adapting the good practice framework developed in Delahunty and Putt’s research for general use within metropolitan areas

Prevalence and Risk Factors of Elder Maltreatment among Chinese Americans

abstract: All ethnic groups in the U.S. have suffered from elder maltreatment (EM), but literature on this topic among Chinese Americans is sparse. Only one group of researchers has exclusively focused on the EM experiences of Chinese Americans in the U.S. A recent study indicated the prevalence rate of EM was 24% among residential-dwelling Chinese American elders and the most prevalent forms of EM are psychological maltreatment (10%) and financial maltreatment (10%). However, the effect of family relationship and cultural factors on EM have not yet been explored. The traditional Chinese culture emphasizing family cohesion and filial piety, along with the acculturation stress and language barriers may increase the risks of EM in this population. This exploratory research aimed to understand EM perpetrated by family members in residential settings among Chinese American elders and the risk factors of EM in this population, focusing on the Phoenix metropolitan area. Particularly, understanding EM through both a cultural lens and a legal lens shed light on the roles of socio-cultural variables (family support and cultural variables) associated with EM among Chinese American elders, one of the fastest growing ethnic groups in the U.S. To achieve these research aims, a larger quantitative component building on a small qualitative component was utilized. In Phase I, focus groups were conducted to ensure subsequent survey questions were culturally and linguistically appropriate. Feedback from the focus groups was used to refine the questionnaire designed for this study. In Phase II, revised questionnaires were distributed to 266 Chinese American older adults to detect EM prevalence and to identify the factors associated with victimization. The ecological theory provides guidance for the study. In the end, one of ten Chinese American elders experienced general EM perpetrated by family members. The dominant forms of EM, elder neglect and emotional maltreatment, may have serious emotional outcomes and threaten the well-being of Chinese elders. To prevent the occurrence and recurrence of EM, service professionals and gatekeepers in the community need to work with Chinese American families to reduce elders’ depression levels, promote family cohesion and eliminate the intergenerational culture/acculturation differences.Dissertation/ThesisDoctoral Dissertation Social Work 201

Nurse perceptions of elder self-neglect

The purpose of this study was to determine how experienced home health nurses perceive elder self-neglect. An additional purpose of the study was to explore steps these nurses employ to intervene when self-neglect is suspected. Self-neglect is a complex phenomenon that is poorly understood. Salient features of this phenomenon include the failure of individuals to take the steps needed to provide for their basic needs, comfort and safety. Common presentations have been described as disheveled, unkempt individuals living in cluttered, filthy homes. Yet, these individuals give no indication there is any cause for concern. Although self-neglect can be found in the literature dating back to the late 1960's, there is a paucity of research of this phenomenon. Previous studies have focused on describing the manifestations of self-neglect, and a few have offered definitions. However, to date, there is a wide range of definitions of self-neglect and thus, a lack of clarity in understanding the phenomenon. Because self-neglect is manifested as a failure to provide for personal needs as well as maintaining the living environment, home health nurses are poised to identify these individuals. However, only three studies were found focused on nurses, and none of those studies focused on nurses who make home visits. This is the first study of self-neglect focused on home health nurse perceptions of the phenomenon. This qualitative, descriptive design of home health nurses (N=16) revealed nurses' perceptions that resulted into five global themes: (a) armor, (b) psychological derivation, (c) seclusion, (d) nonconformity with self-care conventions, and (e) nurses' responses. These nurses could readily identify signs of self-neglect in their clients including nonconformity with self-care conventions and seclusion. They provided their definition for this phenomenon but reported receiving no education on self-neglect either in their pre-licensure programs or since entering practice. These home health nurses identified both facilitators and barriers to providing nursing care to this population, and experienced ethical questions of autonomy and beneficence in providing that care. Study participants attributed self-neglect to psychological issues, although expressed that none of these clients were medically diagnosed with a mental illness or disorder. The results of this study have implications for nursing education and practice as well as public policy decisions. Further studies on self-neglect are needed to develop educational strategies to inform nursing practice. Exploration of the impact that public policy has on these elders who are vulnerable and marginalized is paramount. Nurses should assume lead roles in future studies of self-neglect

Awareness of trigger events among clinicians working with elders with dementia : a project based upon an independent investigation

This qualitative study was undertaken in order to determine what clinicians perceive to be trigger events that influence dementia onset and if these events are used in the therapeutic process. This study asked the following research questions: What is your experience as a clinician working with elders who have dementia? As a clinician, what is your understanding of trigger events? How do you incorporate the knowledge of triggers into your therapeutic process? Tell me about the types of events that you have found that trigger elderly onset of dementia: medical? Trauma? Etc? What specific techniques have you found helpful in working with elders with sudden onset of dementia? Participants were recruited by the snowball data collection technique by contacting a professional network of clinicians in person and by e-mail and telephone. Thirteen participants completed a face-to-face or telephone interview. The findings of the research showed that clinicians shared a basic knowledge of trigger events to dementia including emotional trigger events. However, clinicians reported a different understanding of the way in which these events trigger dementia than this researcher originally hypothesized. Clinicians do report using the knowledge of trigger events in therapy as a way to discern coping skills and identify areas to address