Linda S. Noelker

Care-related stress. A comparison of spouse and adult-child caregivers in shared and separate households.

This research examines the role that relationship and household arrangement have in explaining the levels of care-related stress effects experienced by spouse and adult-child caregivers in shared and separate residences. Data from 180 spouse and adult-child caregivers were analyzed to identify differences in caregiver health decline, relationship strain, and activity restriction across these settings when the effects of elder impairment, caregiver age, and use of social supports are controlled. Results show that spouse and adult children in shared households experience similar levels of care-related strain. However, comparison of adult children in shared and separate households show considerable cross-setting differences in strain, with those in shared households having significantly greater activity restriction but less relationship strain. These findings have implications for the delivery of social services, specifically for targeting health monitoring, respite, and family counseling services.

Impact of Arts Participation on Health Outcomes for Older Adults

The objective of this study was to present findings from a literature review on the documented health benefits of arts programs for older adults. A systematic literature review was conducted to examine research publications on participatory arts programs for older adults and their reported impact on health outcomes. A total of 2,205 articles were found. Of these, 11 were eligible for inclusion. The review describes the effects of participation in art programs on a variety of health outcomes. The small number of empirical studies documenting the health impact and limitations in their design prohibit broad generalizations, however, findings suggest there are physical and mental health benefits for older adults from arts participation.

Family Satisfaction With Nursing Home Care for Relatives With Dementia

Families of residents with dementia from five nursing homes were interviewed to assess if they believed improvements were needed in the care provided to their relatives. Quality of care was assessed in a variety of service and staff areas that factored into two domains of care: (a) environmental and administrative services and (b) direct care. Families who perceived significant improvements were needed in environmental and administrative services had more negative interactions with staff, perceived nurse assistants as being insensitive, and helped relatives with more activities of daily living (ADL). With respect to direct care, families perceived significant improvements were needed when they had more negative interactions with staff and helped their relatives with more ADL. These findings highlight the importance of promoting positive familystaff interactions, providing direct care in a sensitive manner, and exploring the reasons why families get involved in ADLto improve family satisfaction with care.

Social Integration, Health, and Choice Their Impact on the Well-Being of Institutionalized Aged

This research examined the importance of social integration, compared with self-rated health and feelings about entry and residence in an institution, for the subjective well-being of aged in long-term care settings. Additionally, various measures of social integration were investigated and several appeared as more salient predictors of resident morale, life satisfaction, and satisfaction with treatment. These measures, which were directed to the nature rather than the quantity of social interaction, included being visited by a preferred family member or friend, receiving assistance from others, giving assistance to others, and participating in organized social activities.

Sidney Katz, MD: A New Paradigm for Chronic Illness and Long-Term Care

Dr. Sidney Katzs legacy to the field of gerontology is internationally recognized as his success at developing standardized measures and processes, beginning with the activities of daily living index, for the functional assessment of older adults with chronic conditions necessitating long-term services and supports. That work served as the bedrock for his subsequent major accomplishments, which improved rehabilitation services through interdisciplinary team work and attention to the patient-family constellation; reformed the regulation of nursing homes, refocusing it on resident outcomes and quality of life; and promulgated the concept of active life expectancy as a new approach to measuring the quality of later life. Few other scholars and researchers in the history of the field of aging can claim one, much less multiple monumental contributions leading to major advances in the treatment of chronic illness and the quality of long-term care.

Impact of family members on nurse assistants: What helps, what hurts

This qualitative study focuses on nurse assistant reports of both positive and negative behaviors exhibited by family members of cognitively impaired residents. The information reported is obtained from in-person interviews with 114 nurse assistants in 5 skilled nursing facilities (3 philanthropic, 2 proprietary) in Greater Cleveland, Ohio. Nurse assistants were predominantly female (89 percent), white (60 percent), with a mean age of 33, and had been caring for cognitively impaired nursing home residents for an average of five years. Content analyses of nurse assistants’ responses reveal five categories of family members’ positive behaviors and four categories of negative behaviors. This article focuses on these themes and suggests topics for educational interventions for family members and nurse assistants who care for cognitively impaired nursing home residents. Topics include coping with family members’ feelings of guilt and related behaviors, understanding longstanding family relationship issues, and understanding possible reasons for decisions family members make regarding care of their relatives.

Improving Policies for Caregiver Respite Services

This paper provides a template for the decade ahead regarding the delivery, supply, and funding of caregiver respite services. Policy changes are needed to address these issues as concerns about our countrys ability to meet future caregiving needs are growing along with our aging population. Federal initiatives and state-level policies and programs affecting respite are reviewed and directions for policy advancement are highlighted. Much more work is needed to educate caregivers and the general public about the necessity for respite beginning early in the caregiving career to prevent burnout and other adverse effects. Because it is unlikely that there will be a sufficient number of direct-care workers to replace unpaid caregivers, improved policies are needed to ensure that their situation is sustainable through increased availability of high-quality respite and other services vital to caregiver health and well-being. Among the 2015 White House Conference on Agings priorities in the next decade, policies on long-term services and supports will require focused attention on family caregivers and the direct-care workforce to strengthen their ability to give care now and support their own physical, emotional, and financial needs in the future.

Losing An Aged Relative: Perceptual Differences between Spouses and Adult Children

Research on bereavement primarily focuses on conjugal loss; few studies examine differences between losing a spouse and losing an aged parent. The present investigation compares perceptions of nineteen bereaved spouses with forty-seven bereaved adult children in order to specify differences between conjugal and parental loss. Data from two larger surveys of family caregivers show spouses feel their physical and emotional health has been more negatively affected by the death, yet report increased participation in social activities. Adult children are more likely to discuss dying with an ill parent, although little difference occurs in other preparations. Differences between spouses and children also are found in the appraised difficulty of the death and in the number of peripheral sources of support, and in the likelihood of receiving assistance from friends and neighbors.

Racial differences in social integration and life satisfaction among aged public housing residents

The effects of social activity, social resources, health, and functional status on the life satisfaction of black and white aged were examined, based on interviews with 330 residents of age-integrated and age-segregated public housing estates in Cleveland, Ohio. The results of multivariate analysis call into question previous conclusions that age-segregation is conducive to greater life satisfaction. However, the findings do lend support to previous research indicating that social integration has a greater degree of importance in determining the life satisfaction of black than of white aged.

Residential Choice and the Well-Being of Aged and Disabled Public Housing Residents

This research examined the importance of residential preference and perception of environmental quality, along with health, socio-economic status, and social integration, in determining mode among public housing residents. Participants of this research included a random sample of 427 aged and disabled public housing residents. Findings fmm this research substantiate the importance of residential choice and perception of environmental quality along with health, social integration and knowledge about resources and services for psychological well-being in public housing.