Process and structure: Service satisfaction and recommendation in a community-based elderly meal service in Shanghai This study aims to examine elderly clients’ service satisfaction and service recommendation for community-based meal services in Shanghai by applying Donabedian’s (1988) quality-of-care framework. This study analyzed secondary data from randomly sampled elderly clients of a community-based meal program in the Jing’an District in Shanghai (N = 690). Findings identified that several structure and process factors were significantly related to respondents’ service satisfaction and service recommendation. Notably, these factors were not identical; we discussed the differences. This study adds evidence in urban China to advanced research on quality of care. Read more
A self-reliant umbrella: Defining successful aging among the old-old (80+) in Shanghai The Chinese old-old (80+) population has steadily increased in recent years; however, limited studies have examined how this group ages. The purpose of this study is to explore how the old-old in urban China define successful aging. Guided by grounded theory, we conducted semi-structured, in-depth interviews with community-dwelling old-old participants (N = 97). Participants identified self-reliance as the goal of successful aging, which was supported by four proactive behaviors: physical activity, financial security, community connectedness, and willing acceptance of reality. In our model, we conceptualized these four proactive behaviors to constitute the ribs of an umbrella, supporting a canopy to protect the pole of self-reliant successful aging. This study offers new understanding of the dynamic and nuanced ways that the old-old in urban China age successfully and of their valiant efforts to maintain self-reliance. Read more
The influence of acculturation level and family relationships on quality of life among U.S. Chinese older adults The present study examined the influence of acculturation level and family relationships (i.e., positive family support and negative family strain) on quality of life (QOL), using the data from the Population Study of ChINese Elderly (PINE) in Chicago (N = 3159). Controlling for sociodemographic variables and health status, it was found that individuals’ acculturation level and positive family support were positively related to QOL, whereas negative family strain was negatively associated with QOL. More importantly, higher acculturation levels were associated with increased protective effects of positive family support and reduced risk effects of negative family strain on QOL among U.S. Chinese older adults. Read more
Promoting Heart Health and Behavior Change in a Vulnerable Older Adult Population Background: Older minority populations in low socioeconomic classes are at high risk for cardiovascular disease, stroke, type 2 diabetes, and a host of other heart-related health conditions. Engaging in unhealthy behaviors such as poor diet, sedentary lifestyle, and poor use of health services is a major contributor to these health disparities. The Heart Health Program was developed to improve health outcomes by encouraging behavior change in a group of low-income older African Americans attending two urban senior centers. Using the Health Belief Model as a guiding framework, group sessions were conducted bi-weekly over the course of a three-month period. Session leaders engaged participants in educational activities and helped to develop individual ‘action steps’, or actionable goals for each participant to strive toward as a means of improving heart health. Methods: Twenty-five low-income, African American seniors participated in the Heart Health Program. A prepost design was used to evaluate the acceptability and feasibility of the program. Results: Participants reported high levels of satisfaction with the program as a whole and successful accomplishment of action steps. Results indicate limited long-term behavior change at the program’s conclusion. Conclusions: Lessons were learned about implementing this type of behavior change program in a senior center focused on: preparation, logistics, and relationships between the project team, senior center staff, and participants. Based on the initial experience of the Heart Health Program, plans are underway to refine the program and broaden its delivery to more older adults. Read more
Measuring Cultural Justifications for Caregiving in African American and White Caregivers Objectives: This report will elucidate the psychometric properties of the Cultural Justifications for Caregiving Scale (CJCS) and evaluate the differences in cultural values and demographic variables among a group of African American and White caregivers. The CJCS measures the cultural reasons for and expectations about providing care to an older relative. Methods: CJCS data were collected from 202 adults caring for an older relative with memory loss. The factor structure of the CJCS was analyzed for reliability and its correlation with other measures pertaining to the caregiving experience. Results: Exploratory factor analyses suggested two underlying factors relating to Duty and Reciprocity with high levels of reliability. The two factors showed different correlational patterns with other measures associated with the caregiving experience (CG demographics and well-being). Discussion: Findings provide further evidence that the CJCS is a reliable measure for use with African American and White caregivers. Moreover, cultural motivations to provide care may differ for ethnically diverse CGs based on religious backgrounds and beliefs about family expectations surrounding the care of loved ones. The application of the CJCS is also discussed. Read more
Religiosity and Quality of Life A Dyadic Perspective of Individuals With Dementia and Their Caregivers Objectives: Dyadic coping theory purports the benefit of joint coping strategies within a couple, or dyad, when one dyad member is faced with illness or stress. We examine the effect of religiosity on well-being for individuals with dementia (IWDs). In particular, we look at the effect of both dyad members’ religiosity on perceptions of IWDs’ quality of life (QoL). Neither of these issues has been extensively explored. Method: One hundred eleven individuals with mild-to-moderate dementia and their family caregivers were interviewed to evaluate IWDs’ everyday-care values and preferences, including religious preferences. Using an actor_partner multi-level model to account for the interdependent relationship of dyads, we examined how IWD and caregiver ratings of religiosity (attendance, prayer, and subjective ratings of religiosity) influence perceptions of IWDs’ QoL. Results: After accounting for care-related stress, one’s own religiosity is not significantly related to IWDs’ or caregivers’ perceptions of IWD QoL. However, when modeling both actor and partner effects of religiosity on perceptions of IWDs’ QoL, caregivers’ religiosity is positively related to IWDs’ self-reports of QoL, and IWDs’ religiosity is negatively associated with caregivers’ perceptions of IWDs’ QoL. Conclusion: These findings suggest that religiosity of both the caregiver and the IWD affect perception of the IWD’s QoL. It is important that caregivers understand IWDs’ values concerning religion as it may serve as a coping mechanism for dealing with dementia. Read more
Elder Abuse in India Extrapolating From the Experiences of Seniors in India’s ‘Pay and Stay’ Homes Primary research on the issue of elder abuse and neglect in India is limited due to tremendous reluctance to discuss intergenerational conflicts. Nevertheless, researchers are beginning to identify collective voices of perceptions of abuse and neglect that are more rampant than individuals may directly admit. In this study of senior residents living in India’s “pay and stay” homes, 150 individuals were interviewed in order to understand their relocation experience. Results suggest that challenges in interpersonal family relationships, conflicts in values and perceptions, particularly with regard to neglect and abandonment, are evident in descriptions of the relocation experience. Read more
Racism Reported By Direct Care Workers in Long-Term Care Settings This article focuses on reports of racism experienced by direct care workers (DCWs). These DCWs provide the majority of hands-on care to older residents/ clients that need help with activities of daily living such as bathing and dressing in long-term care (LTC) settings. Interviews were conducted with 644 DCWs working in three types of LTC settings. Proportionate random sampling techniques were used to select 49 LTC agencies from a five-county area in northeast Ohio. The DCWs included nurse assistants in nursing homes, resident assistants in assisted living facilities, and home care aides in home health agencies. Analyses reported include frequencies, chi-square tests, and analysis of variance. Hearing racial and ethnic remarks, particularly from residents/clients, was widely reported by DCWs. Despite this, DCWs were likely to believe that remarks from residents/clients were not intended to hurt their feelings. Although DCWs heard fewer racial/ethnic remarks from family members or other staff, they were likely to believe that such remarks were intended to hurt their feelings. At the organizational level, DCW reports of hearing racial/ethnic remarks in nursing homes were more frequent than those in other LTC settings. Further, DCWs in organizations in which racial differences between them and the residents/clients that they served was very large reported hearing significantly more racial/ethnic remarks. These findings have important implications for addressing racism in LTC agencies with anti-discrimination policies and programs. Read more
Strengthening the Direct Care Workforce Preliminary Recommendations from a National Panel of Experts in Long-Term Care Read more
