Adult Foster Care: Its Tenuous Position on the Care Continuum

Frequently any move away from independent living for an elderly person is viewed as a downhill road to the nursing home and ultimate death. Adult foster care has been viewed as one such step closer to institutionalization. Service provision to the elderly needs to be viewed on a continuum where the elderly are seen as being capable of moving in and out of supportive living arrangements when the need arises. Barriers to providing this care are identified with future needs highlighted

Racial Differences in the Confident Relationship

Numerous researchers have studied the black family in American society. Unfortunately, too few have focused on the role of the family in the life of the elderly. In this paper it is my intention to focus on the strengths and weaknesses of the black family and, in particular, on the black family member as confidant. Frazier, in a book, The Black Family, edited by Robert Staples, discusses the character of the black family during the various stages of its development. He purports that the black family has been affected by the social isolation of blacks in American society. Frazier believes that it has been the family that has aided the black individual\u27s survival in the face of this isolation. The family as the focus of survival is an interesting concept when considering the status of the elderly in America. Segregated groups and existing institutions have hardly provided refuge for the white elderly let alone for the black elderly. It is conceivable that the family plays an important role in the lives of the black elderly as they confront the changes and crises of growing old in America

Stress of the Caregiver: Effective Management of Dementia Patients in Hospital and Community Settings

This study explores the management problems among elders with dementia and their medical and family caregivers. Twenty-five patients were interviewed as well as professional health care personnel and a family member. Findings indicated that professional assessment facilitates home caregiving but has little bearing on successful coping by the caregiver. Variability of coping relates to the strategy employed

Age-Friendly Environments and Self-Rated Health: An Exploration of Detroit Elders

While a number of organizations and government entities have encouraged the development of more “age-friendly” environments, to date there has been limited research linking these environment features to elder outcomes. Using a representative sample of older adults living in Detroit, this study examined the association between age-friendly environment factors and self-rated health. Results indicated that access to health care, social support, and community engagement were each associated with better self-rated health, while neighborhood problems were associated with poorer self-rated health. Moreover, individual-level income and education no longer predicted self-rated health once age-friendly environment factors were taken into account. These findings highlight the need for more research documenting the effects of age-friendly environments, particularly across diverse contexts and populations

Conceptualizing age-friendly community characteristics in a sample of urban elders: An exploratory factor analysis

Accurate conceptualization and measurement of age-friendly community characteristics would help to reduce barriers to documenting the effects on elders of interventions to create such communities. This article contributes to the measurement of age-friendly communities through an exploratory factor analysis of items reflecting an existing U.S. Environmental Protection Agency policy framework. From a sample of urban elders (n =1,376), we identified six factors associated with demographic and health characteristics: Access to Business and Leisure, Social Interaction, Access to Health Care, Neighborhood Problems, Social Support, and Community Engagement. Future research should explore the effects of these factors across contexts and populations

Do Age-Friendly Characteristics Influence the Expectation to Age in Place? A Comparison of Low-Income and Higher Income Detroit Elders

Currently there is limited evidence linking age-friendly characteristics to outcomes in elders. Using a representative sample of 1,376 adults aged 60 and older living in Detroit, this study examined the association between age-friendly social and physical environmental characteristics and the expectation to age in place, and the potential differences between low- and higher-income elders. Based on U.S. Environmental Protection Agency’s (EPA) age-friendly guide, we identified six factors reflecting age-friendly characteristics. Logistic regression models indicated that regardless of income level only neighborhood problems were significantly associated with expecting to age in place. Low-income elders were more likely to expect to age in place than their higher-income counterparts, and it is unclear whether this resulted from a desire to remain in the home or that there is no place else to go. Future research should address the ways in which financial resources affect the choices, expectations, and outcomes of aging in place

Gender differences in distress and depression following cardiac surgery

This study examined the effects of physical health and other psychosocial variables on psychological distress and depression following coronary artery bypass graft surgery (CABG), with a focus on gender differences. Information regarding psychological distress one year following surgery was obtained from a sample of 151 patients (112 males, 39 females), who also provided retrospective information about noncardiac chronic conditions, preoperative socioeconomic variables, postoperative social support, and immediately post-CABG depression. Medical and surgical data and postoperative cardiac conditions were retrieved from computerized medical records. Structural equation modeling with LISREL showed that distress one year following surgery was predicted by the number of noncardiac chronic illnesses, controlling for immediately post-CABG depression. Gender had only an indirect effect on distress; women reported more chronic medical conditions than did men. Analysis also revealed an interaction between gender and income: higher income men and lower income women were most likely to report depression immediately following surgery.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91264/1/Ai et al -1997-Gender differences in distress and depression following cardiac surgery JGCH.pd

Assessing Capacity for Self-Care among the Aged

Data drawn from the Supplement on Aging (SOA) to the 1984 National Health Interview Survey (NHIS) were used to identify correlates of older persons' assessments of their capacity to provide self-care. The SOA data set consists of responses, based on personal interviews with 16,148 persons 55 years of age and older. Most assessed their capacity to care for themselves in positive terms; only 11% assessed their capacity to provide self-care as fair or poor. Based on stepwise regression, self-reported health status and perceived control of health accounted for approximately 15% of the 17% of variation explained in the dependent variable. The Health Belief Model may provide a theoretical context in which to understand better the self-care component of the health-care continuum.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66585/2/10.1177_089826438900100402.pd