Lenard W. Kaye

GERONTOLOGICAL KNOWLEDGE AND ATTITUDES OF STUDENTS OF RELIGION

Abstract As society ages, the age profiles of religious congregants will also increase. Will students of religion have the necessary knowledge and normative orientations to work with the elderly? This article reports on a study that examined the perceptions, experiences and expectations of students of religion (N = 142) and their graduate counterparts (N = 216), by means of structured interviews. Rosencranz and McNevins Aging Semantic Differential, Palmores Facts on Aging Quiz and original indices were used to operationalize the study variables. Results revealed more positive attitudes toward young than old people. Relatively low gerontological knowledge scores were realized as well as negative biases toward the aged. Positive correlations emerged between knowledge and attitudes toward older people as well as between knowledge and priority assigned to working with the aged. Positive attitudes were associated with an “increasing optimism” toward the years ahead. Study findings lead to curricula developme...

Racial/ethnic disparities in access to medicare home health care: the disparate impact of policy.

The Balanced Budget Act of 1997 dramatically decreased reimbursements for traditional Medicare home health patients. A multivariate analysis of Medicare Current Beneficiary Survey data showed that African American and “other” users experienced greater decreases in home care between 1996 and 1998 than did White users. These results suggest (a) race/ethnicity is an independent factor in determining service use post-BBA and (b) health policy has a disparate impact on minority older adults. Capitated payment systems must be pursued cautiously to avoid negative effects on vulnerable populations. The potential for current and future Medicare policy changes to negatively affect vulnerable populations is also discussed.

Assessing the efficacy of ombudsman services for the aged in long term care institutions

Long term care ombudsman programs are a recently established component within the gerontological services continuum. Public policy in this area is not yet well defined and there is a conspicuous absence of systematic studies assessing the effectiveness of such program efforts. This research reports on the accomplishments of an urban based, volunteer nursing home ombudsman program. Survey findings show moderate levels of goal attainment in the policy and social relations domains and more promising results in the organizational/managerial sphere. The relationship between perceptions of program success and varying ombudsman role behaviors is underscored.

Intervention with Abused Older Males: Conceptual and Clinical Perspectives

SUMMARY Men and women experience abuse in different ways and older men have particular treatment needs that must be addressed by clinicians. The current design and configuration of clinical services may create barriers to abused older men receiving treatment fully suited to their needs. In this article, the unique experiential dynamics and help seeking behaviors of older men who experience abuse are delineated and recommendations are given for structuring services to better meet their needs. Gender-sensitive clinical techniques and modalities are described and suggestions for interventions that could prove particularly efficacious in the treatment of older men are offered.

Early intervention screening for family caregivers of older relatives in primary care practices: establishing a community health service alliance in rural America.

The Maine Primary Partners in Caregiving project provides a prime example of how disparate community health, social service, and higher education institutions can build a successful rural service alliance for the purposes of screening for family members experiencing stress during the provision of care to impaired older relatives. Community primary care practices are featured as prime sites for the early identification of elder caregivers experiencing stress and burden. Initial project results and implementation challenges as well as recommended strategies for nurturing such community partnerships are presented.

Who Cares for Caregivers? Evidence-Based Approaches to Family Support

Currently, more than one in 10 Americans are caregivers, and projections suggest exponential increases in caregiving in the years ahead. Not only is the population growing older, but the spike, in particular, created by the aging of some 78 million baby boomers portends far greater demand. Families continue to represent the lion’s share of caregivers and their caregiving efforts are substantial in every sense of the word. Nationally, 15.4 million caregivers provide approximately 17.5 billion hr of unpaid care valued at more than

Beneficiary profiles and service consumption patterns in an urban Medicaid home and community-based waiver program.

216 billion (Alzheimer’s Association, 2014). Estimates suggest that at least 90% of older adults who receive care obtain it from their families, either unaided or supplemented by paid care (Houser, Gibson, & Redfoot, 2010). Older adults who require caregiving receive, on average, 20 hr of assistance each week (MetLife Mature Market Institute, 2006). Traditionally, family caregiving has involved assistance with daily activities (e.g., bathing, dressing) and household activities (e.g., shopping, managing finances). In recent years, the caregiver role has expanded to include performance of increasingly complex medical/nursing tasks for care recipients who have multiple chronic physical and cognitive conditions. These tasks include managing multiple medications, handling incontinence needs, helping with the adoption of assistive devices, and more (Reinhard, Levine, & Samis, 2012). Although this shift in the type of care families provide

Factors Affecting Nursing Home Patient Participation in a Volunteer Grievance Resolution Service

The research reported here was conducted as part of a larger program evaluation of an urban Medicaid Home and Community Based-Waiver Program (HCBS). Informed by a secondary analysis of data collected on 723 clients, this article describes the association between client demographics and service consumption patterns among program beneficiaries with emphasis on access to care issues. The majority of the clients were female, African American, nearly 80 years of age, receiving approximately

THE LEARNING AND RETENTION OF TEACHING SKILLS BY OLDER ADULTS: A TIME SERIES ANALYSIS

600 of monthly income. Although White clients on average were higher functioning, they were hospitalized more frequently and took more medications than African American or Hispanic clients. Clients who were bedbound, Hispanic, and most dependent in performing activities of daily living received the fewest “number of services.” Clients who suffered the most severe intellectual impairment, living with a spouse, and with the highest incomes received the most “units of service.” Interestingly, service usage did not always increase as the client became more dependent in Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (LADLs), and mobility. The significance of findings is considered in relation to access to care issues.

Substance abuse exposure among youth being raised by grandparents in rural communities: findings from a three-year evaluation.

Critical preconditions for effective program performance with vulnerable popula tions are service visibility and staff commitment. These factors may be especially important for patient representative programs serving the elderly in long term care institutions. Data collected from 210 residents in 14 skilled nursing and health- related facilities and 24 volunteer providers of nursing home ombudsman services suggest factors that may influence patient utilization of a mechanism for grievance resolution. Significant associations were found between both patient variables (age, education, sex, race) and facility variables (auspice, level of care, quality of care) and program awareness, service utilization, awareness of personal rights, and fear of retaliation. Patient representatives displayed intense altruisitc impulses, frustration with staff apathy in institutions and altered outlooks toward old people and institu tional care. Findings point to the value of personal advocacy with institutionalized aged populations, volunteer incentives and advocate career ladders, focused exper tise in selected health problem situations and flexible role behaviors in nursing home settings.