Margaret B. Neal

The stability of core and peripheral networks over time

Abstract This article uses data on ‘network instability’ to show how differences across multiple measurements on the membership of personal networks can yield important insights into the nature of these networks. The data come from a sample of 234 recent widows, aged 59–85, who completed seven interviews about their networks over a 1-year period. We use these data to investigate the stability of both overall networks and individual ties, as well as the linkage between the stability of individual ties and the stability of the networks aggregate properties. We find that instability in these networks is best thought of in terms of an underlying ‘core-periphery’ structure, whereby some network members are likely to be named repeatedly (the core), while others are relatively unlikely to appear in any given elicitation of the network (the periphery). We explore the implications of this core-periphery structure for cross-sectional elicitations of personal networks.

The Moderating Effects of Work-Family Role Combinations and Work-Family Organizational Culture on the Relationship Between Family-Friendly Workplace Supports and Job Satisfaction

This study determined whether work-family role combinations (i.e., work and elder care, work and child care, work and elder care and child care) and work-family culture significantly moderate the relationship between availability of workplace supports and job satisfaction. The data were obtained from the Families and Work Institute’s 1997 archival data set, the National Study of the Changing Workforce (NCSW). As predicted, the relationship between availability of workplace supports and job satisfaction varied depending on the type of work-family role combinations and levels of work-family culture. Specifically, the relationship was significant for the elder care work-family role combination, in that higher levels of workplace supports in unsupportive work-family cultures were associated with the greatest levels of job satisfaction. In addition, it was found that a supportive work-family culture and an increase in workplace supports were related to a slight decrease in job satisfaction for the elder care work-family role combination.

Working Sandwiched-Generation Caregivers: Prevalence, Characteristics, and Outcomes

Some workers today are caring for family members at both ends of the life span—children and elders. This first national study specifically of dual-earner couples in the sandwiched generation examin...

Job Burnout and Couple Burnout in Dual-earner Couples in the Sandwiched Generation

We use existential theory as a framework to explore the levels of and relationship between job and couple burnout reported by dual-earner couples in the “sandwich generation” (i.e., couples caring both for children and aging parents) in a sample of such couples in Israel and the United States. This comparison enables an examination of the influence of culture (which is rarely addressed in burnout research) and gender (a topic fraught with conflicting results) on both job and couple burnout in this growing yet understudied group of workers who are reaching middle age and starting to face existential issues as part of their own life cycle. Results revealed significant differences in burnout type (job burnout higher than couple burnout); gender (wives more burned out than husbands); and country (Americans more burned out than Israelis). Job related stressors and rewards as well as parent care stressors predicted job burnout, and marital stressors and rewards predicted couple burnout. In addition, there was evidence for both crossover and spillover.

Collaboration Among Siblings Providing Care for Older Parents

Abstract As their parents age, adult siblings must find ways in which to jointly assist in their care. Based on a sample of 40 focus group participants who described caregiving relationships among siblings, this study focused on those who equitably shared in the care of their parents. Findings indicated that siblings distributed caregiving responsibilities by taking turns as well as by caregiver task and/or expertise. Factors associated with sibling collaboration were: redefining the caregiving system, enjoying time together, setting aside time for care planning, and implementing suggestions from aging parents. Practice implications highlight ways in which to facilitate this collaboration.

Caregiving and work: consequences, correlates, and workplace responses

The American population is aging, and the fastest growing segment is those most likely to need care: persons age 85 or older. At the same time, women, the traditional caregivers, are entering and staying in the labor force in ever increasing numbers. To ensure that needed workers will be available and remain productive, more and more employers are trying to help employees manage both their work and their caregiving duties. The research on employees who are informal caregivers to elder family members and the workplace‐based programs designed to assist these caregiving employees is reviewed. In particular, findings concerning the prevalence of caregiving among employees, the characteristics of employee caregivers, the effects of caregiving on employees and their work and of work on caregiving, the types of workplace accommodations made, and the types of workplace initiatives implemented are summarized. The implications of the phenomenon of employee caregiving for the education and training of professionals ...

Age-Friendly Portland: A University-City-Community Partnership

This article addresses the question of how creating an age-friendly city has come to be an important policy and planning issue in Portland, Oregon. In 2006, researchers from Portland State Universitys Institute on Aging examined the meanings of age friendliness among a broad range of participants in Portland, Oregon. The research was conducted in conjunction with the World Health Organizations (WHO) Age-Friendly Cities project and followed the completion of two earlier non–WHO-related projects. The city of Portland, through the Institute on Aging, was one of nine original members to apply for and be accepted into the WHO Global Network of Age-Friendly Cities and Communities. An Age-Friendly Portland Advisory Council was formed to guide the development of an action plan, monitor progress over time, and suggest additional research. To understand how Portlands age-friendly policy effort has developed over time, we use Kingdons (1984) agenda-setting framework to explain how the policy problem was formulated, how solutions were developed, and the influence of local politics. The policy actors, including individuals and organizations working within and outside of government, are described. The Portland experience provides a case study that other cities, especially those with a strong commitment to community-engaged urban planning, may find useful as they develop age-friendly initiatives.

Effects of Accommodations Made at Home and at Work on Wives' and Husbands' Family and Job Satisfaction

Abstract As part of a larger national study of 309 dual-earner couples caring both for children and aging parents, participants were surveyed about the behavioral accommodations they made at home (e.g., limiting time spent with family) and at work (e.g., changing work schedules), and about their satisfaction levels in both domains. Results indicated that wives made more frequent accommodations than did husbands, both at work and at home. Accommodations made were related to satisfaction in a number of ways. For both husbands and wives, the extent to which a spouse made accommodations at home was negatively related to their own family satisfaction.

Falls prevention education: Interprofessional training to enhance collaborative practice

ABSTRACT The gap between the complex health care needs of older adults and the availability of geriatrics-trained health care professionals is widening. Interprofessional education offers an opportunity to engage multiple professions in interactive learning and clinically relevant problem solving to achieve high-quality patient-centered care. This article describes a project that engaged an interprofessional teaching team to support interprofessional practice teams to reduce falls in older adults via implementation of evidence-based practice guidelines. Ninety-five participants from 25 teams were trained on multiple strategies to decrease the risk of falls in older adults. The intervention facilitated increases in knowledge, confidence in skill performance, and team commitment to change practice patterns to support the health and safety of older adults. Findings suggest that community-based practices can successfully support the training of interprofessional teams and that training may lead to improved care processes and outcomes for older adults.

An Interprofessional Approach to Reducing the Risk of Falls Through Enhanced Collaborative Practice

Falls are the leading cause of accidental deaths in older adults and are a growing public health concern. The American Geriatrics Society (AGS) and British Geriatrics Society (BGS) published guidelines for falls screening and risk reduction, yet few primary care providers report following any guidelines for falls prevention. This article describes a project that engaged an interprofessional teaching team to support interprofessional clinical teams to reduce fall risk in older adults by implementing the AGS/BGS guidelines. Twenty‐five interprofessional clinical teams with representatives from medicine, nursing, pharmacy, and social work were recruited from ambulatory, long‐term care, hospital, and home health settings for a structured intervention: a 4‐hour training workshop plus coaching for implementation for 1 year. The workshop focused on evidence‐based strategies to decrease the risk of falls, including screening for falls; assessing gait, balance, orthostatic blood pressure, and other medical conditions; exercise including tai chi; vitamin D supplementation; medication review and reduction; and environmental assessment. Quantitative and qualitative data were collected using chart reviews, coaching plans and field notes, and postintervention structured interviews of participants. Site visits and coaching field notes confirmed uptake of the strategies. Chart reviews showed significant improvement in adoption of all falls prevention strategies except vitamin D supplementation. Long‐term care facilities were more likely to address environmental concerns and add tai chi classes, and ambulatory settings were more likely to initiate falls screening. The intervention demonstrated that interprofessional practice change to target falls prevention can be incorporated into primary care and long‐term care settings.