Amanda S. Barusch

Predictors of Life Satisfaction in Frail Elderly

Abstract This study examined the relationship between life satisfaction and physical status, emotional health, social support and locus of control in the frail elderly. A random sample of 99 low-income, frail elderly living in the community was interviewed. Almost 40% of participants reported high levels of life satisfaction. Multiple regression analysis identified four significant predictors of life satisfaction: Perceived physical health, social support, emotional balance, and locus of control. Physical health emerged as the most significant predictor of life satisfaction accounting for 14% of the variance. Social support, emotional balance and locus of control each accounted for an additional 6% of the variance in life satisfaction. All four predictors explained 32% (R= .57) of the total variance in life satisfaction. Implications for practice and recommendations are discussed.

Depressive Symptoms in the Frail Elderly: Physical and Psycho-Social Correlates

The elderly who suffer from chronic illness are at unusually high risk of depression and depressive symptoms. This study was conducted to describe the prevalence of depressive symptoms in a sample of chronically-ill elders and to examine the relationship between physical illness and depression, both as it is illuminated in a regression model and as it is understood by the respondents themselves. Interviews were conducted with a random sample of 100 clients in a community-based care program for low-income elderly at risk of nursing home placement. Over one-third of the sample (36%) reported significant depressive symptoms, as measured by the CES-D. Multiple regression analysis identified functional limitations, cognitive impairment and self-perception as significant correlates of depression in a model that explained 30 percent of the variance in CES-D scores.

Examining Foundations of Qualitative Research: A Review of Social Work Dissertations, 2008-2010.

This study examined the treatment of epistemology and methodological rigor in qualitative social work dissertations. Template-based review was conducted on a random sample of 75 dissertations completed between 2008 and 2010. For each dissertation, we noted the presence or absence of four markers of epistemology: theory, paradigm, reflexivity, and power. We also examined methods choices and the strategies used for ensuring rigor. Results suggested that most (96%) doctoral students completing qualitative dissertations address theory, but fewer refer to reflexivity (45%), paradigm (13%), or power dynamics (8%). Students typically used multiple strategies for ensuring rigor. Grounded theory and phenomenology were the most popular methods choices, followed by case studies, ethnography, or narrative methods. Implications for doctoral education are offered.

Self-Concepts of Low-Income Older Women: Not Old or Poor, But Fortunate and Blessed.

This article examines the extent to which low-income older women define themselves in stigmatizing terms, then explores the strategies they use to preserve a positive sense of self. Instead of considering themselves “old” or “poor,” the sixty-two women interviewed defined themselves as “fortunate” and/or “blessed.” The ability to see oneself as fortunate may be a significant component of successful aging.

Fostering coping skills and resilience in Home Enteral Nutrition (HEN) consumers.

BACKGROUND Home enteral nutrition (HEN) is a lifesaving therapy that provides benefits along with countless challenges. This qualitative study examined how HEN consumers learned to cope successfully with HEN-related challenges and uncovered how healthcare providers could help foster the process of coping in other HEN consumers. METHODS Twelve adult HEN consumers who perceived that they were coping successfully and overcoming the adversity associated with HEN, and met the criteria for resilience using the Resilience Scale, self-selected for the study. Participants engaged in a series of 2 in-depth interviews. Data were coded and analyzed using grounded theory methodology. RESULTS One overarching theme and 5 main categories emerged from the data, revealing that these individuals coped successfully with HEN by developing an attitude of personal responsibility to accept new life conditions, take charge of their own well-being, seek and accept support, maximize independence and normality, and focus on the positive. In addition, these participants used a variety of problem- and emotion-focused coping strategies and shared resilient characteristics such as self-efficacy and perseverance. CONCLUSIONS Implications for clinical practice and HEN education, along with suggestions for healthcare providers to foster coping with HEN are provided. An educational manual with self-help suggestions for adult HEN consumers is also available at http://www.copingwell.com.

Disaster, Vulnerability, and Older Adults: Toward a Social Work Response

After the devastating earthquake in Christchurch we all feel vulnerable here in New Zealand, but as reports from Tokyo remind us, when it comes to disasters, older adults are most vulnerable of all. As of March 23, 65% of the 2,853 people known to have died in Japan’s earthquake and tsunami were over 60 years old, and an estimated 46% were 70 or older (House of Japan, 2011; Majiroxnews, 2011). These figures are high, even for a nation with one of the world’s oldest populations. Older adults make up 23% of Japanese, nearly twice their proportion in the United States. Kansai University professor Yoshiaki Kawata explained that older people have higher mortality rates because they move more slowly. He suggested that “The central and local governments should review the way they evacuate the elderly and impress upon young people that they should help out in an emergency” (House of Japan, 2011; Majiroxnews, 2011). Evacuation plans are necessary but clearly not sufficient. MSNBC reported that 14 seniors died, presumably of exposure, after being moved from a hospital near the damaged Fukushima nuclear plant to temporary shelter in a school gym (MSNBC, 2011). Apart from that, when the sky is falling it is hardly reasonable to expect 25-year-olds to risk their own lives to help straggling elders. But what is reasonable? This editorial will briefly consider factors that contribute to the vulnerability of older adults in times of disaster and outline some considerations that might inform our social work contribution to disaster preparedness and response.

The Aging Tsunami: Time for a New Metaphor?

The aging tsunami is gaining momentum and I’m not talking about population demographics. It’s the metaphor. Google’s new Ngram Viewer shows a dramatic rise in the use of the phrase “age wave” since the 1980s, and a quick Google search yields over 8,000 hits for “aging tsunami” in the news. Japan is “bracing” for it, Iran is “threatened,” and Hawaii is preparing for a “coordinated effort.” In the Pacific we have experience with tsunamis: great walls of water that destroy or displace everything in their path and then recede, leaving nothing behind but rubble, salty mud, and broken lives. There’s nothing human about a tsunami. It’s a nasty metaphor for older adults. Andrea Charise (2012) points out that “it testifies to the barely conscious figurative language that serves to construct perceptions of an aging population”—inaccurate, damaging perceptions, at that.

Social Support and Caregiver Strain: Types and Sources of Social Contacts of Elderly Caregivers

Informal social supports have been consistently associated with the physical and mental well-being of the elderly. In this study the associations between sense of strain and three types of social support are described for a sample of 131 spouse caregivers. Adverse social contacts were associated with increased strain, while positive contacts were insignificant. When sources of social support were examined daughters figured prominently, as important sources of both positive and adverse social contacts. Findings also emphasize the importance of interventions which include friends, neighbors, and others.Informal social supports have been consistently associated with the physical and mental well-being of the elderly. In this study the associations between sense of strain and three types of social support are described for a sample of 131 spouse caregivers. Adverse social contacts were associated with increased strain, while positive contacts were insignificant. When sources of social support were examined daughters figured prominently, as important sources of both positive and adverse social contacts. Findings also emphasize the importance of interventions which include friends, neighbors, and others.

Age-Friendly Cities: A Social Work Perspective

Anyone who has watched an ancient woman make her way along a city crosswalk well after the “don’t walk” sign has begun flashing is aware of the hazards of growing old in an urban environment. Age slows us down and makes us vulnerable to a range of assaults, from isolation to fast traffic, from fear of crime to air pollution. Recognizing this and the increasing age and urbanization of human life on earth, the World Health Organization (WHO; 2007) has called on cities to become more age-friendly as “ . . . a necessary and logical response to promote the wellbeing and contributions of older urban residents and keep cities thriving” (p. 4). Here I will briefly explore the progress of this global movement and reflect on the potential contributions of social workers.

Narrative Gerontology Coming Into Its Own

Twentieth-century literary critic Roland Barthes (as cited in CzarniawskaJoerges, 2004) observed that “narrative is present in every age, in every place, in every society; it begins with the very history of mankind and there nowhere is nor has been a people without narrative” (p. 1). Given movie depictions of Cro-Magnons as linguistically challenged savages, it may be hard to imagine the Stone Age men who walked across the Bering land bridge to populate North America during the last ice age as tellers of stories. But evidence in support of Barthes’ claim might be found in the stars. Bradley Schaefer’s grandfather taught him to identify the “big bear” constellation, Ursa Major, in the Colorado sky, no doubt setting the stage for his career in astronomy. Now, Schaefer (2006) argues that the history of Ursa Major can only be explained with reference to “a chain of grandfathers stretching from Paleolithic Siberia to the mountains and plains of the New World and eventually to modern Colorado, telling about the Bear in the sky” (p. 97). The story of constellations, as we have come to understand it, begins in the Fertile Crescent (stretching across Iraq, Syria, and adjoining lands). Thousands of years before humans walked to the New World, our ancestors lived by farming along the banks of great rivers—the Tigris and the Euphrates. From time to time the river would flood, washing away possessions and jeopardizing lives, but also depositing nutrient-rich silt that would support crops. Hardwired to identify patterns, humans eventually noticed that the movements of stars across the sky could be used to predict the coming flood. As is so often the case with great discoveries, this insight probably did not arrive as a single “aha!” moment, more likely occurring to several people in different locations at different times. Each one developed a method for recognizing the stars and each one developed a story to help identify those stars and describe their movement to younger generations. The easiest way to describe a cluster of stars was to point up and say, “See those stars that look like a big ladle, like a Big Dipper? Now see how these other stars trace the outline of a bear followed by three hunters?”