Mark Brennan

Social Networks of Aging Gay Men

Social support becomes an increasingly important resource for people as they age. Research has shown that the needs of older gay men are no different than those of their heterosexual counterparts, nor are older gay men more isolated than older men in general. Research has shown gay men rely on friendship networks more often than on family while heterosexual men rely more on family for social support. Using the most conservative estimates, there are more than two million gay men over the age of 60 in the United States. Results from the first large-scale research project of caregiving in the gay and lesbian communities in NYC challenge the myth of the isolated aging gay man. Two hundred-thirty three gay men, ages 50–87, reported an average of five friends, with whom they were close. Thirty-six percent were partnered, and nearly 90% reported at least fair health and being at least somewhat satisfied with their lives, despite 30% reporting feelings of depression. Results dispel the myth that gay men are not involved with their biological families; when present, biological family members were close to and maintained contact with respondents. Yet relatives were much less likely to be called upon for help. Respondents were most likely to turn to partners, if available, followed by friends.

Prevalence and Risk Factors for Self-Reported Visual Impairment Among Middle-Aged and Older Adults:

This study examined the prevalence of and risk factors for self-reported visual impairment among American adults. Data were collected via telephone interviews with a nationally representative sample (n= 1,219) aged 45 and older and were weighted for population parameter estimates. Hierarchical logistic regression examined independent risk factors of self-reported visual impairment. Seventeen percent of adults aged 45 and older self-reported visual impairments, increasing to 26.5% of those aged 75 and older. Greater age, not being Hispanic, in poor or fair self-rated health, and low availability of informal social support were significant risk factors associated with visual impairment. The prevalence of vision problems among adults suggests unmet needs for both basic eye care and vision rehabilitation interventions to reduce functional limitations that can result from visual impairment. Longitudinal research is needed to examine prevalence and incidence of vision loss as a function of population aging and changing health behaviors.

Longitudinal associations between dual sensory impairment and everyday competence among older adults.

Given the prevalence of sensory impairment in older adults, the relationship of sensory impairment to everyday competence among older adults is gaining attention. Dual impairment, or concurrent impairments of vision and hearing, affects anywhere from 5% to 21% of older adults. Using Longitudinal Study on Aging data, we examined the longitudinal associations of self-reported dual sensory impairment with everyday competence in self-reported activities of daily living among adults aged 70 and older (N = 5,151). Self-reported dual sensory impairment was associated with higher levels of self-reported functional disability at baseline and at the 2-year follow-up interview, but the effect gradually diminished over time. However, self-reported dual sensory impairment was not associated with greater levels of self-reported disability as compared with self-reported visual impairment alone. Findings highlight the importance of vision and aural rehabilitation programs for older adults to mitigate the loss of competence in later life due to sensory impairment.

Spirituality and Psychosocial Development in Middle-Age and Older Adults with Vision Loss

The purpose of this study was to examine the buffering effects of spirituality on stress resulting from vision status, health status, and from other significant life events as related to psychosocial development according to Eriksons 8-stage theory. Participants were middle-aged and older adults with recent vision loss who had applied for vision rehabilitation services (n = 195). The regression model included independent factors of sociodemographic variables, life stress measures (i.e., vision status, health status, and life experience ratings), mediating variables (i.e., spirituality, religiousness, and social support), and the outcome of psychosocial development. Spirituality was found to play a buffering role on the effects of negative life experience impact and control ratings. Vision impairment status did not appear to either promote or hinder psychosocial development.

In their own words: Strategies developed by visually impaired elders to cope with vision loss.

Abstract The present study developed a typology of self-reported coping strategies used by older adults in adapting to vision impairment using qualitative analyses. Narrative data were examined from three previous quantitative studies of adaptation to vision loss. Major themes in coping with vision loss included difficulty in balancing norms of independence with the functional losses resulting from eye disease, and the importance of the informal social network. Importantly, a number of coping mechanisms that have not been examined in prior quantitative work were identified through the present qualitative analyses. Implications of this typology of self-reported coping with age-related vision loss for research and practice are discussed.

Why Do They Leave? Factors Associated With Job Termination Among Personal Assistant Workers in Home Care

Recruiting and retaining an adequate number of personal support workers in home care is both challenging and essential to allowing elders to age in place. A mixed-method, longitudinal study examined turnover in a sample of 261 personal support workers in Maine; 70 workers (26.8%) left their employment in the first year of the study. Logistic regression analysis indicated that younger age and lack of health insurance were significant predictors of turnover. Analysis of telephone interviews revealed three overarching themes related to termination: job not worthwhile, personal reasons, and burnout. Implications of study findings for gerontological social workers are outlined.

Tackling Vision-Related Disability in Old Age: An Application of the Life-Span Theory of Control to Narrative Data

This study used the life-span theory of control (Heckhausen, J., & Schulz, R.) to examine adaptation to disability in old age. A narrative approach to data collection was used to assess the strategies employed by 364 older adults with macular degeneration to deal with daily challenges. Findings revealed a rich array of strategies. Compensatory Primary Control was reported by nearly all respondents, Compensatory Secondary Control by a majority, and Selective Primary Control by half of the participants. Selective Secondary Control was the least reported. Differences in strategy use depending on level of vision impairment were the most pronounced within the category of Compensatory Primary Control for strategies that involved using help from others and alternative means. Within the category of Selective Secondary Control, effort to maintain a positive outlook was associated with higher impairment levels, whereas within the category of Compensatory Secondary Control, attempts not to dwell on problems related to vision were associated with lower impairment levels. Implications for conceptual development and future research are discussed.

Religious Congregations and the Growing Needs of Older Adults with HIV

By 2015, half of those with HIV will be over age 50. This group has a high level of needs, lacks social supports, and will need to access community services such as those provided by religious congregations. We examined whether disclosure to a congregation would pose a barrier to accessing congregational services among adults 50 and older with HIV (n = 819). Fifty-three percent had disclosed, but those who did not disclose generally remained engaged with their congregations. Findings suggest that congregations can be a feasible source of support for older adults with HIV.

Introduction: Spiritual Assessment and Intervention: Current Directions and Applications

SUMMARY There is a growing literature documenting the positive effects of religiousness and spirituality. As a result, the assessment of spirituality, and interventions that tap into this personal resource, are becoming increasingly the focus of research and practice in many populations, including older adults. Spiritual assessment may include a variety of modalities that obtain information about a persons spiritual well-being, history, crises or dilemmas. Such assessments are used to guide pastoral care and/or interventions. Any programs, policy, procedure, or protocol that address the spiritual well-being and needs of individuals can be considered a spiritual intervention. These interventions may consist of activities that strengthen, reinforce or promote the spiritual and religious resources of individuals, or that utilize existing spiritual resources present in the individual to address well-being and needs regarding spirituality and other life domains. It is imperative that as this work moves forward, spiritual assessment and intervention be firmly grounded both conceptually and empirically, and that high standards of scientific rigor are maintained in research and application. Without such attention to detail, both basic and applied research may lack the credibility to make a strong case for meeting the needs of older adults through spiritual assessment and intervention.

Chapter 4 The September 11th Attacks and Depressive Symptomatology Among Older Adults with Vision Loss in New York City

Abstract Responding to the September 11, 2001 terrorist attacks, the NIH Office of Behavioral and Social Science Research developed a measure to assess bias in studies of mental health resulting from these events. Studies that have reported a negative mental health impact from September 11th have focused on adults of all ages and have had limited preattack comparison data. However, at the time, we were studying depression among older adult vision rehabilitation applicants in the New York City metro area. Thus, we were in an unique position to examine any potential biasing effects of September 11th given our proximity to one of the attack sites. CES-D scores and life satisfaction were compared for those providing data 2 months prior (n = 111) or 2 months after September 11th (n = 58). Significant biasing effects of September 11th did not emerge, nor were there any interaction effects of the event with age, gender or education. Failure to find bias from September 11th in our Sample reflects, in part, the resiliency of older adults who have coped with other stressful events in their lifetimes.