Joseph G. Pickard

Aging in Place or Relocation: Perceived Awareness of Community-Based Long-Term Care and Services

ABSTRACT This study used data from the Community Partnership for Older Adults Program Survey (N = 4,611) to examine associations between the perceived awareness of community-based long-term care and supportive services and the anticipation for aging in place and relocation. Respondents varied substantially in their knowledge about services and anticipation for aging in place and relocation. Perceived availability and unavailability of a series of community services was associated with the likelihood of anticipating aging in place and relocation, and awareness of the lack of visiting nurses, personal assistance, or transportation was related to respondents reporting a younger age at which they anticipated needing help to age in place or anticipating a need to relocate. Findings have implications for raising the public awareness of community-based services in addressing the needs of community-dwelling elders for aging in place and relocation.

Anticipating relocation: concerns about moving among NORC residents.

Summary Most older adults prefer to live at home as long as possible, requiring supports and services to help them age in place. This study examines the relocation concerns of a group of older adults in a suburban naturally-occurring retirement community (NORC). Twenty-six percent of the 324 residents interviewed expressed concern about having to move in the next few years. Residents who were worried differed from those who did not worry on a number of demographic and biopsychosocial characteristics. Overall, residents present a profile of vulnerability that calls for preemptive action to help them stay in their homes. A NORC is an ideal setting in which to provide supportive services.

The relationship of religiosity to older adults’ mental health service use

This article uses data from the Naturally Occurring Retirement Community (NORC) Demonstration Project (N = 326) to examine older adults’ utilization of mental health services. This study is guided by the behavioral model of health service utilization and helps to fill gaps in the literature by including religious affiliation, religiosity, and interaction terms as variables in regression models. These variables are important, as religion is more important in the lives of older adults than in the lives of their younger counterparts. This study found the rate of use of mental health services during the previous six months to be 19.0%, and those with higher levels of private religious activity and higher levels of intrinsic religiosity are more likely to have accessed some form of mental health service. However, frequency of attendance at religious services is not associated with the use or non-use of services. Information from this study suggests that more research is needed to specify the manner in which religious affiliation and religiosity work to affect the use of mental health services, and future studies must include religious variables in order for models of service use to be complete.

Clergy as mental health service providers to older adults

Older adults tend to seek help for emotional problems from clergy at greater rates than they do from other sources. However, their help-seeking from clergy is largely understudied. We used data from the Naturally Occurring Retirement Community (NORC) Demonstration Project to examine older adults’ patterns of help-seeking from clergy. We studied a sample of adults aged 65 or older (n = 317) to determine which factors were related to help-seeking from a religious leader. This study was framed within the Behavioral Model of Health Services Utilization. Results of hierarchical logistic regression analyses indicated that having less social support and greater frequency of attendance at religious services was related to help-seeking from clergy for this sample, while other predisposing, enabling, need and religiosity variables were not found to be related to help-seeking from clergy. Discussion focuses on the need for mental health workers to be aware of the important role that clergy play in service provision and to find ways to leverage knowledge and skills to enhance provider–clergy relationships in order to improve services that older adults receive.

The Relationship of Social Support to African American Caregivers' Help-Seeking for Emotional Problems

This study analyzes whether social support serves as a link to or substitute for formal services among African American female caregivers seeking help with emotional problems. It also analyzes other determinants of help-seeking. It relies on data from the Black Rural and Urban Caregivers Mental Health and Functioning Study and is guided by a modified version of the behavioral model of health services use. Using hierarchical binary logistic regression, analyses reveal that only age, stress, and support from fellow church members are statistically significantly associated with the likelihood of help-seeking. These results support the linking hypothesis, suggesting that the social support received by African American women caregivers in the context of their religious organizations helps to link them to services.

Older Drivers Retiring From the Road: An Application of the Selection, Optimization, and Compensation Model

Purpose: This study uses the selection, optimization, and compensation (SOC) model to compare older adults who have given up driving, those who still drive, and those who drive less to identify differences in the three groups. Design and Methods: This cross-sectional study of 281 older adults is part of the Naturally Occurring Retirement Community Demonstration Project. Study participants completed interviews that included questions on demographics, health and functioning, mental health, social support, and current levels of engagement in activities including current driving status. Results: Data suggest that driving retirement is a process and that a substantial number of people are in the transitional stage, where they are less functional than those who still drive and more similar to those who have retired from the road. Implications: Given the similarity of those who drive less to those who have given up driving, front-line professionals and policy makers must work together to ease the transition to driving retirement for those without adequate ability to effectively compensate for their inability to continue to drive safely.

Stakeholder Perspectives on Policies to Support Family Caregivers of Older Adults With Dementia

Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to relatives with dementia, access to home- and community-based services, and the potential benefits of a consumer-directed service model. The authors conducted three focus groups with family caregivers (N = 25) in eastern Missouri who were recruited through support groups and service providers. Family caregivers reported difficulty in acquiring services, high levels of psychological and physical stress, greater need for caregiving supports, and a desire for public policy change to support caregiving families. Caregivers cited differences in knowledge, family relationships, and health and employment circumstances as reasons why they would prefer a traditional case management model, a consumer-directed care model, or a cash and counseling model. Family caregivers suggested that surrogate decision making within consumer-directed care should, at minimum, be an available option. Findings from this study offer initial support for the advancement of family-centered care models in home- and community-based dementia care practices and policies to support the caregiving efforts of families.

Self-Esteem Mediates the Relationship Between Volunteering and Depression for African American Caregivers

Research on the influence of volunteering on mental health outcomes has not placed enough focus on African American female caregivers who are at risk for adverse outcomes such as depression. This study addresses this gap by examining the mechanism through which volunteering might influence depressive symptoms using data collected from 521 African American female caregivers of older adults. Regression results indicate that although volunteering is inversely associated with depressive symptoms, self-esteem mediates this relationship. Findings suggest inclusion in volunteering for African American female caregivers may be relevant to promotion of their mental well-being.

Videos: Where do they fit in an aging infused social work curriculum?

ABSTRACT As technology progresses, college instructors are presented with the availability of new and exciting pedagogical methods. Though the use of videos is not new, their use is becoming increasingly simplified and relevant to popular culture. This conceptual paper presents a theoretical rationale for the use of videos as a teaching and learning tool in the infusion of aging content into the social work curriculum, provides in-class strategies with a case example, and discusses the use of videos outside of class.

Professionals' Beliefs About Nursing Home Regulations in Missouri

The process of nursing home regulation continues to need improvement to ensure the best possible quality of care. This study uses mixed methods to explore opinions of nursing home professionals and state nursing home regulation inspection team members about the regulation process and ideas for changing it in the State of Missouri. Data come from a survey of nursing home professionals (n = 334) and state regulation inspectors (n =123) conducted in early 2004. Findings show disagreement about who is responsible for facilitating nursing home compliance; nursing home professionals desire state assistance in interpreting and applying regulations, whereas inspectors do not believe this will improve quality of care. Greater focus on resident needs may provide common ground for bridging this divide and developing interventions to ensure regulatory success.