Adrienne L. Cohen

Social Supports as Enabling Factors in Nursing Home Admissions Rural, Suburban, and Urban Differences

This study investigates differences in social support and nursing home admission by rurality of residence. We use discrete-time event history models with longitudinal data from seven waves (1998-2010) of the Health and Retirement Study to prospectively examine the risk of spending 30 or more days in a nursing home (n = 5,913). Results show that elders with a health problem who live in rural areas of the South or Midwest have approximately 2 times higher odds of nursing home entry than elders living in urban areas in the Northeast. Rural elders report somewhat higher social support than non-rural elders, and controlling for these forms of social support does not explain the higher risk of a nursing home stay for Southerners and Midwesterners living in rural areas. Results suggest that social support has a similar association with nursing home entry for rural, suburban, and urban elders.

Family Assistance and Autonomy in the Lives of Rural Elders

This research seeks to better understand how rural elders receive assistance from family members while still maintaining a sense of autonomy. In-depth interviews with rural elders explored both assistance and autonomy. Results indicate that rural elders are able to receive assistance from family members while maintaining autonomy through a range of strategies, including purposefully giving over control to others when needed and relinquishing control before it is taken away. Lessons learned here guide formal service providers to permit elders to direct their own care planning and implementation, thereby allowing them to maintain a level of autonomy.

Student Journals: A Means of Assessing Transformative Learning in Aging Related Courses

In courses where topics are sensitive or even considered taboo for discussion, it can be difficult to assess students’ deeper learning. In addition, incorporating a wide variety of students’ values and beliefs, designing instructional strategies and including varied assessments adds to the difficulty. Journal entries or response notebooks can highlight reflection upon others’ viewpoints, class readings, and additional materials. These are useful across all educational levels in deep learning and comprehension strategies assessments. Journaling meshes with transformative learning constructs, allowing for critical self-reflection essential to transformation. Qualitative analysis of journals in a death and dying class reveals three transformative themes: awareness of others, questioning, and comfort. Students’ journal entries demonstrate transformative learning via communication with others through increased knowledge/exposure to others’ experiences and comparing/contrasting others’ personal beliefs with their own. Using transformative learning within gerontology and geriatrics education, as well as other disciplined aging-related courses is discussed.

Support Network Connectedness in the Lives of Community-Dwelling Rural Elders and Their Families

ABSTRACT Rural elders face challenges when accessing assistance from family, neighbors, and paid helpers. This support is essential to allow them to remain community dwelling as they develop physical challenges that limit their ability to care for themselves. This qualitative study followed a group of 16 rural elders with physical limitations for 1 year. In-depth interviews were conducted with them and eight members of their support networks, including five family members, to explore how rural older adults create and maintain support networks that allow them to remain community dwelling despite physical challenges that limit their self-care. The research question is, “How do members of the support network connect with each other to maximize the effectiveness of the network?” Family members coordinated assistance to maximize the abilities and availability of various network members. In addition, family members worked together with other family members, neighbors, and paid helpers to assist the elder. These strategies enhanced the ability of the network to assist the rural elder and also lessened the burden of care by dispersing it among network members.