Judith G. Gonyea

Subjective appraisal of Alzheimer's disease caregiving: The role of self-efficacy and depressive symptoms in the experience of burden:

Most studies investigating correlates of Alzheimers disease (AD) caregiver burden have focused on the role of objective factors as opposed to subjective factors. Although objective variables (e.g., caregiver age, patient dementia severity, functional status) have been shown to be significantly associated with burden, the correlations generally are modest and explain relatively little of the variability in caregiver outcomes. Moreover, many of these objective variables are not modifiable and are of limited use in the development of caregiver interventions. Thus, there continues to be a need to identify powerful and modifiable determinants of caregiver burden. This study examined the role of two subjective factors—self-efficacy and depressive symptoms—as predictors of AD caregiver burden. Based on a sample of 80 AD caregivers, hierarchical regression analyses revealed that self-efficacy and depressive symptoms each had a significant independent effect on the experience of burden even after accounting for objective factors. These findings suggest that caregiver interventions aimed to reduce burden may benefit from the incorporation of specific strategies to increase self-efficacy and decrease depressive symptoms.

Adult daughters and aging mothers: The role of guilt in the experience of caregiver burden

Although guilt is often identified as being a common emotion experienced by family caregivers in the clinical literature and in small descriptive studies, it has only recently emerged as a construct in the empirical research focused on identifying predictors of caregiver distress. Using Pearlins stress process model, and based on data from 66 midlife adult daughters caring for aging mothers, we explored the extent to which guilt contributes to caregiver burden. Hierarchical regression analysis revealed that guilt was positively correlated with burden and that it accounted for a significant amount of the variance in caregivers sense of burden even after contextual and stressor variables were controlled. Our research suggests the importance of clinicians seeking to understand how individuals judge their caregiving performance and targeting negative self-appraisals, which affect individuals’ mental health, for change. The challenge for clinicians is to help guilt-ridden caregivers revise their evaluative standards and engage in self-forgiveness and self-acceptance.

The Complexities of Elder Homelessness, a Shifting Political Landscape and Emerging Community Responses

Despite their growing numbers, homeless older adults remain largely invisible in society and there has been a pervasive lack of public focus on elder homelessness. In this article, we seek to shine light on this forgotten population and deepen understanding of difficult challenges they confront in regaining housing security. We also examine the shifting political climate regarding homelessness, particularly the enactment and subsequent reauthorizations of the McKinney–Vento Homeless Assistance Act, and how these shifts are influencing community responses to elder homelessness. Finally, future challenges and policy directions for breaking the cycle of elder homelessness in the U.S. are discussed.

Reducing Poverty Among Older Women: Social Security Reform and Gender Equity

The authors document the higher poverty rate of older women, especially women of color, compared with older men—a pattern created and maintained by the intersection of the structural factors of age, race, and marital status. They then review how the U.S. Social Security program generally benefits older women and reduces their late-life economic vulnerability. A persistent gender inequity, however, is that women are more likely to disrupt their paid employment to meet family care responsibilities, which may increase the number of zero-earnings years and reduce the amount paid into Social Security. Current proposals to privatize the Social Security system are critiqued in terms of their gender inequities. Three relatively revenue-neutral proposals that could increase Social Securitys protection against poverty and differentially affect low-income women are briefly discussed.

The Family and Dependency

This research investigated the planning by family members for the institutionalization of their elderly relatives. Institutional decision-making was conceptualized as having four stages: recognition; discussion; implementation; and placement. The key question explored was what are the most salient structural and dynamic factors associated with the first three stages of institutional decision-making, and do these critical factors vary with each stage. Multivariate analyses revealed that both sets of variables make independent contributions to the prediction of the caregivers involvement in each stage of decision-making. The implications of the findings for future research and practice are discussed.

Fractured Identity: A Framework for Understanding Young Asian American Women's Self-harm and Suicidal Behaviors.

Despite the high suicide rate among young Asian American women, the reasons for this phenomenon remain unclear. This qualitative study explored the family experiences of 16 young Asian American women who are children of immigrants and report a history of self-harm and/or suicidal behaviors. Our findings suggest that the participants experienced multiple types of “disempowering parenting styles” that are characterized as: abusive, burdening, culturally disjointed, disengaged, and gender-prescriptive parenting. Tied to these family dynamics is the double bind that participants suffer. Exposed to multiple types of negative parenting, the women felt paralyzed by opposing forces, caught between a deep desire to satisfy their parents’ expectations as well as societal expectations and to simultaneously rebel against the image of “the perfect Asian woman.” Torn by the double bind, these women developed a “fractured identity,” which led to the use of “unsafe coping” strategies. Trapped in a “web of pain,” the young women suffered alone and engaged in self-harm and suicidal behaviors.

The Nonprofit Sector's Responsiveness to Work-Family Issues

Although researchers have explored the growth and impact of family-supportive policies in the business sector, there has been a curious lack of attention to the development of family-responsive policies in the nonprofit sector. This article suggests possible explanations for the dearth of such studies, reviews the existing literature, and offers directions for future research examining the kinds of work environments and policies that attract and retain high-quality employees in nonprofit organizations. Such research is critical as a growing number of workers, both men and women, are seeking ways to balance a desire for meaningful work with a wish for fuller family or personal lives.

Improving Health Care Delivery to Aging Adults With Disabilities: Social Work With Dual Eligibles in a Climate of Health Care Reform

Adults aging with disabilities comprise a diverse group. In this article, we identify the prevalence and characteristics of this target population, focusing on adults who are dually eligible for Medicare and Medicaid. We articulate challenges in the delivery of health, social, and support services to adults aging with disabilities, particularly how existing health care policy and financing contributes to fragmentation of care. Finally, we identify opportunities for social workers to advocate for and promote system improvements in the delivery of care for aging adults with disabilities in the current climate of health care reform.

Aging Well at Home: Evaluation of a Neighborhood-based Pilot Project to “Put Connection Back into Community”

There is growing interest, in the United States and globally, to transform communities to become more aging friendly. However, the majority of emerging initiatives lack a formal evaluation component, limiting our understanding of their effectiveness and the ability to replicate them. This study is an evaluation of a pilot project, the Aging Well at Home (AWAH) Program, which aimed to “put connection back into community” to support the psychological well-being of urban seniors who were aging in place. We examined AWAHs effect on stress, loneliness, and depression through interviews with 33 seniors at enrollment and at 9 months later. Findings revealed a significant decline in participants’ perceived stress (p < .001); however, AWAH was less successful in lessening loneliness (p < .09) and was not associated with any change in depression (p > .33). In self-assessments, the majority of participants reported a greater sense of self-efficacy and social connection as a result of AWAH participation. The study offers preliminary evidence of the utility of a neighborhood approach to improving older adults’ quality of life.

Loneliness and Depression Among Older Adults in Urban Subsidized Housing

Objective: Depression is particularly prevalent in low-income and disabled older adults, and minority populations face a greater risk of poverty and earlier disability onset. Yet, little is known about the mental health of older subsidized housing residents, a population which is disproportionately composed of persons of color. The study’s aim was therefore to explore the prevalence and correlates of depression in this target population, with a particular focus on the role of loneliness. Method: Data are from interviews with 216 older subsidized housing residents, of which 50% identified as Black and 45% self-identified as Latino. Results: About 26% of participants met the criterion for depression. The hierarchical regression supported our hypothesis; after controlling for demographic, health, and stress variables, loneliness explained almost half of the total 49% of variance in depression. Discussion: Care models addressing social risk factors are needed to meet the aging-in-place challenges of subsidized housing residents.