Michael N. Kane

Factors Affecting Social Work Students’ Willingness to Work with Elders with Alzheimer’s Disease

This study sought to determine factors that affect social work students’ willingness to work with the growing number of elders with Alzheimer’s disease. An in-class survey of 333 BSW and MSW students at three Florida universities throughout 1996 produced data on measures of the dependent variable (willingness to work with elders with Alzheimer’s disease) and 16 independent variables (potential influences). Path analysis and a stepwise regression analysis allowed construction of a model with a prediction variance of 54%, indicating that the principal contributing variables are willingness to work with elders, previous close contact with elders, close contact with elders with Alzheimer’s disease, and preference for working with older versus younger clients. These and some less influential factors suggest ways that social work educators can encourage students to serve this vulnerable population.

Awareness of ageism, motivation, and countertransference in the care of elders with Alzheimer's disease

This article focuses on the importance of a practitioners awareness of ageism, motivation, and countertransference in working with elders with dementia. These factors have the capacity to significantly affect a professionals performance. Additionally, they may also affect the type and quality of services a memory-impaired client receives. Ageism is discussed at the micro, mezzo, and macro level, and practitioners are urged to develop an increased awareness of the effects of ageism on client/service options and as well as practitioners beliefs. Monitoring professional motivation and being aware of countertransference are important considerations in practitioner-client relationships. Professionals are encouraged to incorporate personal introspection and consultation or supervision to ensure that clients receive the most appropriate service available. Case examples are provided to illustrate concepts.

AGEISM AND INTERVENTION: WHAT SOCIAL WORK STUDENTS BELIEVE ABOUT TREATING PEOPLE DIFFERENTLY BECAUSE OF AGE

BSW and MSW students randomly completed one of two vignettes that were identical with the exception of the age of the vignettes subject. Following the vignette, respondents responded to 16 bio-psycho-social assessment and intervention items relating to health, illness, aging, and death. The multivariate analysis of variance was significant (F = 1222.587, p = .000) by the Wilks Lambda Criterion. Tests of between-subjects effects yielded eight significant item variables; including the likelihood of recovery, perceptions of the subject having lived long-enough, the appropriateness of ending ones life, and whether the subject should receive psychotherapy.

Factors associated with risk for unprotected receptive and insertive anal intercourse in men aged 40 and older who have sex with men.

Abstract The frequency of HIV infection is increasing in men who have sex with men (MSM) aged 40 and older yet little is known about factors that influence their risky sexual behavior, such as sexual positioning. The goal of this study was to examine multi-level factors associated with unprotected receptive anal intercourse (URAI) and unprotected insertive anal intercourse (UIAI) in MSM aged 40 and older. A community-based sample of 802 self-identified MSM aged 40–94 years was recruited through targeted outreach from community venues (e.g., bars, social events) in South Florida and completed an anonymous pen-and-paper questionnaire. Logistic regression showed that younger age (i.e., aged 40–59; odds ratio [OR]=0.6; 95% confidence interval [CI]: 0.4, 0.9), HIV-positive status (OR=2.8; 95% CI: 1.9, 4.0), drug use (OR=2.6; 95% CI: 1.7, 3.7), a larger number of male sexual partners (OR=1.7; 95% CI: 1.3, 2.3), and lower scores on internalized homonegativity (OR=0.9; 95% CI: 1.0, 1.0) were associated with higher risk for URAI. Younger age (OR=0.4; 95% CI: 0.3, 0.6), HIV-positive status (OR=1.5; 95% CI: 1.0, 2.1), drug use (OR=1.6; 95% CI: 1.1, 22.3), Viagra use (OR=1.7; 95% CI: 1.2, 2.4), larger number of sexual partners (OR=2.1; 95% CI: 1.6, 2.9), and holding views more characterized by high optimism concerning the future (OR=1.1; 95% CI: 1.0, 1.1) were associated with higher risk for UIAI. These results provide useful information that may guide the development of tailored prevention interventions to reduce the growing rates of HIV among MSM aged 40 and older.

Perceptions of South Florida Hispanic and Anglo Catholics: From Whom Would They Seek Help?

Hispanic and Anglo Catholics in South Florida who attended Sunday services (N = 473) were surveyed to determine their help-seeking preferences for moral concerns, mental disorders, and practical life/family problems. Respondents were asked to indicate whether they would seek help from a priest; a priest with a degree and license in one of the helping professions (clinical social work, psychology, psychiatry, or mental health counseling); a layperson with a degree and license in one of the helping professions (clinical social work, psychology, psychiatry, or mental health counseling); or if they believed they could deal with the situation without external assistance. The findings suggest that Anglo Catholics prefer assistance from a person who was credentialed in one of the helping professions, whereas Hispanic Catholics would seek help from a priest with or without a background in the helping professions.

Ethnoculturally-sensitive practice and Alzheimer's disease

Alzheimers disease (AD) does not respect the boundaries of ethnicity or culture. Diverse ethnocultural groups adapt to the stresses of AD in their own unique fashion. As the attitudes, values, help-seeking and coping behaviors vary from one individual to another, so also does variation exist among the diverse ethnocultural groups. This paper will review current literature regarding several ethnocultural groups, as well as common attitudes, values, helpseeking and coping behaviors. Skills, values, and knowledge for the ethnoculturally-sensitive practitioner are discussed. Finally, case examples are cited.

Consent and competency in elders with Alzheimer's disease

This article will examine the elements of informed consent as they affect elders with Alzheimers disease. The components of voluntariness, information, and competency will be reviewed. Case examples involving involuntary psychiatric treatment, institutionalization, and guardianship are examined as they relate to this vulnerable population. Important themes involve the presumption of competence, autonomy, beneficence, paternalism, and the power differential in the relationship between service provider and service recipient.

How Adequate Do Social Workers Feel to Work with Elders with Alzheimer's Disease?

ABSTRACT In a systematic sample of Florida-licensed clinical social workers (N = 273), this study investigated the correlates of perceived adequacy to work with elders with Alzheimers disease and other types of dementia. Five predictor variables were identified from a standard regression analysis that account for 35.7% of the models adjusted variance: (a) employment with elders (Beta = .225, p = .000), (b) years of experience (Beta = -.125, p = .018), (c) attitude toward working with elders with Alzheimers disease (Beta = .351, p = .000), (d) perceived sufficiency of professional education to work with elders with Alzheimers disease (Beta = .178, p = .002), and (e) attitude toward the delivery of nonclinical services to elders with Alzheimers disease (Beta = .192, p = .000). Overall, respondents perceived their abilities to work with elders as slightly less than adequate. Implications are discussed.

HIV-Related Stigma in Midlife and Older Women

HIV-related stigma has been identified as a barrier to HIV testing and prevention efforts internationally and nationally. Although the prevalence of HIV/AIDS is rapidly increasing in women aged 50 and older, little is known about the HIV-stigmatizing behaviors in this underserved population. In this exploratory analysis we investigated the influence of self esteem, sensation seeking, self silencing, and sexual assertiveness on the HIV-stigmatizing behaviors in 572 women aged 50 to 93. The variables considered in this analysis included subscales for the variables self silencing (Externalized Self Perception, Care as Self Sacrifice, Silencing the Self, Divided Self) and sexual assertiveness (Information Communication, Initiation, Refusal). Contributing predictive variables in the final model included: Self esteem (β = −.190, t = −4.487, p = .000), Care as Self-Sacrifice (β = .125, t = 2.714, p = .007), and Silencing the Self (β = .164, t = 3.290, p = .001). Initiation (β = .108, t = −2.619, p = .009) and Refusal (β = −.091, t = −2.154, p = .032). Implications for social work and health perception regarding HIV prevention in midlife and older women are considered. Development of age- and gender-appropriate strategies assisting women in addressing HIV-stigma and related influences are addressed.

Theory-Based Policy Development for HIV Prevention in Racial/Ethnic Minority Midlife and Older Women

ABSTRACT In 2008, there were more than a million persons with HIV/AIDS in the United States. The CDC (2007) estimates that 15% of persons with HIV/AIDS are over age 50. At greater risk are women of color. Most intervention efforts have focused on intrapersonal aspects of an individual and his or her sexual-risk behaviors, with little or no attention directed toward interpersonal and socioenvironmental considerations of risk and prevention. This paper considers the limitations of current national policies relating to HIV prevention in minority populations, especially among midlife and older women of color. In particular, this paper examines risk and prevention policies in light of ecological perspectives, social capital, and dialogical theories.