Heidi H. Ewen

Should I Stay or Should I Go?: Moving Plans of Older Adults

Abstract Data from a longitudinal study of older adults in an upstate New York county (N = 333) show that poor housing “fit” increases the likelihood that older adults are currently considering a move, as does lower residential satisfaction. Those adults who said only that they “might consider moving” focused on health transitions that might signal a need for a new housing situation. Residential satisfaction predicts actual moves even when controlling for moving plans. Older adults may be “pushed” to make a move by a crisis, but those older adults planning moves tend to be “pulled” into housing arrangements with desirable features.

Peer and Faculty Mentoring for Students Pursuing a PHD in Gerontology

The Graduate Center for Gerontology at the University of Kentucky incorporates three levels of mentoring in its PhD program. This project assessed satisfaction with peer and faculty mentoring and explored their perceived benefits and purposes. Core and affiliate faculty and current and graduated students were surveyed. Participants seemed satisfied with the mentoring they were giving and receiving, although all groups discussed limitations. Peer mentors were seen as social support and advice givers, while faculty mentors were viewed as responsible for direction and skill-building. These results can contribute to the development of new mentorship programs and the modification of existing ones.

Death in the nursing home: an examination of grief and well-being in nursing assistants.

The grief that nurses experience when patients and residents die can be complex and has been linked to both problematic (e.g., depression) and beneficial (e.g., gains in coping) outcomes. In this study, 380 nursing assistants working in the nursing home setting were surveyed to gain an understanding of the relationship between grief and well-being. Findings indicated that participants experienced both distress and growth in their grief. Those who experienced greater distress from grief reported significantly higher levels of burnout and lower levels of psychological and physical well-being. Conversely, participants who experienced greater growth from their grief reported significantly lower levels of burnout, higher levels of psychological and physical well-being, and higher levels of job satisfaction. These findings suggest that grief may be an important determinant of well-being in nursing assistants, which, in turn, may impact quality of care in the nursing home.

Tomorrow Belongs to Those Who Prepare for It Today: Gerontology Doctoral Students Career Aspirations.

This research seeks to examine the characteristics and goals of students enrolled in gerontology doctoral education. The authors seek to identify the unique characteristics of scholars enrolled in the interdisciplinary study of aging and elicit discussion on the ways in which these scholars will contribute to the growth and development of the field. This article describes results from an ongoing longitudinal study examining the relationship between gerontology doctoral education and overarching frameworks that define and advance the field. Four cohorts of first-year doctoral students were invited to participate in an online survey. Results reveal three distinct typologies of gerontology doctoral students: traditional academics, applied specialists, and general educators. Traditional academics are seeking postdoc and tenure-track faculty positions upon completion of the doctoral degree whereas the applied specialists intend to pursue careers in allied health fields or within a government setting. Educators plan to seek academic positions within teaching intensive or balanced teaching-research institutions. Gerontology doctoral students are being trained to serve as leaders in practice and research by linking and integrating multiple perspectives. Doctoral education will continue to facilitate applications of research to practice, identify the meaning of being a “gerontologist,” and to advance the field of gerontology. However, students are entering with diverse academic and professional backgrounds and have varied career goals.

The Grief Support in Healthcare Scale: Development and Testing

BACKGROUND Social support is an important factor to consider in understanding the grief process. However, existing measures of social support fail to account adequately for the unique characteristics of grief experienced by healthcare workers in relation to the deaths of patients or nursing home residents. OBJECTIVE The purposes of this study were to develop and to test a grief support measure specific to the experiences of healthcare workers. METHODS Using a cross-sectional design, 380 nursing assistants completed self-administered surveys focusing on grief and loss in the nursing home setting. Exploratory factor analysis and regression analysis were conducted to test the psychometric properties of the Grief Support in Healthcare Scale (GSHCS) and to investigate the scales relationships with grief outcomes. RESULTS Reflective of the theory of disenfranchised grief, the 15 items of the GSHCS were loaded onto three distinct factors: recognition of the relationship, acknowledgement of the loss, and inclusion of the griever. Reliability was acceptable to high across these factors (Cronbachs α of .89, .86, and .78, respectively). Regression analysis indicated that the three subscales of the GSHCS were related significantly to both distress from grief and growth from grief, yet these relationships were unique for each factor. DISCUSSION This research demonstrated that the GSHCS has acceptable reliability and face validity for understanding grief in healthcare workers and may aid in the development of interventions targeted at enfranchising grief in this population. Additional testing is needed to estimate the validity and the reliability of the scale with other groups of healthcare workers.

Aging in Place or Relocation? Plans of Community-Dwelling Older Adults

This study examines the anticipated housing options of 416 community-dwelling older adults from a semi-rural upstate New York county using data from the first two data collections of the Pathways to Life Quality Study. Aging in place, either with or without home modifications to meet special needs as they arise, is seen as the most likely anticipated housing, followed by moving to a retirement community and living with others. Measures of psychosocial well-being, variables assessing resident satisfaction with current homes, health status, and moving intentions were entered into structural equation models in an effort to predict perceived likelihood of living in select housing arrangements. Our findings indicate that those who were considering a move were more likely to consider retirement communities rather than moving closer to relatives. Home satisfaction measures were related to the anticipation of remaining in ones home with modifications. Factors that can be predictive of ability to successfully age in place, such as better health and social support networks, were not significant. Additional research on moving intentions in conjunction with housing options is needed. Although many new types of senior housing have emerged in recent years, marketing and educational materials may not be reaching the older adult populations.

Influence of Late Life Stressors on the Decisions of Older Women to Relocate into Congregate Senior Housing

Late-life stressors often require individuals to make substantial alterations in behavior and lifestyle and can affect their overall health and well-being. Relocation is a significant life stress, regardless of age. The primary aim of this study is to elucidate the push-pull factors associated with moving into congregate senior housing. The secondary aim is to investigate the decision-making processes and stresses associated with moving into a congregate living environment. Interviews were conducted with 26 women who were new residents in congregate senior housing. Relocation, as expected, was considered to be stressful, although individual differences were found among perceptions of relocation stresses. Women who had made the decision to relocate on their own showed evidence of better psychosocial well-being at the time of the move. One-quarter of the sample chose to move to provide care to another person. As the options for senior housing continue to evolve and the number of adults reaching advanced age continues to increase, it is important to understand the factors that contribute to successful adaptation. This knowledge will enable facility administrators to implement programs and procedures to assist incoming residents with acclimating to their new homes.

Professional and Personal Development in Contemporary Gerontology Doctoral Education

This article reports on the Gerontology Doctoral Student Assessment Model (GDSAM), a comprehensive web-based system premised on developing an evaluation mechanism attuned to the special requirements of advanced graduate education at the doctoral level. The system focuses on longitudinal tracking of selected dimensions of intellectual, professional, and personal progress. This involves interlocking elements of online personal dossier development, student self-rating assessment, faculty assessment of student progress, and a means of communicating interactive and iterative feedback among students and faculty. Preliminary findings from initial data collection using the assessment system indicate that students who have completed and passed their qualifying examinations are more confident in their ability to articulate diverse ideas in professional settings, work in direct contact with research participants, present research findings to scientific audiences, and adjust to the rigors of doctoral education. Additional feedback from participants in the system suggests that, although important ethical issues of confidentiality and appropriate use must be recognized and monitored, the GDSAM has strong potential to provide an appropriate assessment tool at the doctoral level. Implementation of such a system throughout doctoral education in gerontology provides a unique opportunity for tracking the impact and effectiveness of doctoral education in an emergent field as additional programs come on line.

A Model for Aging in Place in Apartment Communities

ABSTRACT The purpose of this article is to introduce a theoretical model for an aging-in-place housing specialist for those living in congregate housing facilities. A “needs assessment” tool is outlined to help facilitate the successful implementation of a Health and Aging Residential Service Coordinator (HARSC), both from a research perspective and from implementation of training curriculum for this specialized population. A model that provides both on- and off-site services is hypothesized to be most effective.

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well as facilitate aging-in-place.