Miriam S. Rose

Successful Aging: Early Influences and Contemporary Characteristics

PURPOSE positing that successful aging has independent, yet related, dimensions that are both objective and subjective, we examine how early influences and contemporary characteristics define 4 groups of people. DESIGN AND METHODS data were gathered from 5,688 persons aged 50-74 years living in New Jersey who participated in telephone interviews. Latent profile analysis defined people who age successfully according to both objective and subjective criteria, neither criteria, and one, but not the other, criteria. Multinomial logistic regression was used to examine the extent to which early influences and contemporary characteristics predict group membership. RESULTS although characteristics observable early in life predict group membership, their influence is modified by current health behaviors and social support. The roles of education and incarceration feature prominently. Marital, work, and volunteer statuses, as well as moderate alcohol consumption, distinguish those aging successfully according to both criteria from the other 3 groups. IMPLICATIONS results help to define successful aging as a multidimensional construct having both objective and subjective dimensions, provide greater clarity regarding its correlates, and increase understanding of its modifiable aspects.

Falls Among Nursing Home Residents: An Examination of Incident Reports Before and After Restraint Reduction Programs

OBJECTIVE: To examine changes in the rate of falling of an experimental group of restrained subjects who underwent restraint reduction, and to compare their rate of falling with a group of subjects who did not have restraint orders during the study period.

Balancing Caregiving and Work: Role Conflict and Role Strain Dynamics

Positing role conflict as a bidirectional construct in which work interferes with caregiving (WIC) and caregiving interferes with work (CIW), this study investigated its antecedents (demands and support of caregiving and work) and consequences (role strain). A national sample of 583 women between the ages of 50 and 64 years identified using random-digit-dial procedures completed a telephone survey. Structural equation modeling revealed that caregiving demands were positively associated with CIW and caregiving burden; instrumental caregiving support reduced CIW and caregiving burden. Work demands were positively associated with WIC, CIW, caregiving burden, and work burden. Emotional workplace support reduced WIC, CIW, and work burden. CIW and WIC were positively associated with caregiving burden; only WIC was positively associated with work burden. Findings suggest that demands and supports related to the caregiving role do not influence work-related role strain; work demands and supports influence role strain experienced from both caregiving and work domains.

Time Use by Frail Older People in Different Care Settings

The way in which time is used is an important aspect of the quality of life in long-term care settings. Time budget data for a 24-hour period were contrasted for 123 people living in a nursing home, in an assisted living facility, or in the community with home health services. Results indicate that the days of frail older people are largely spent alone and at home. Obligatory activities account for 38.6% of the day, whereas discretionary activities account for 59.7%. Time spent in activities varies as a function of personal characteristics, environmental context, and social context. Although there are differences across these settings, there are also striking similarities, particularly with respect to social context and satisfaction with the day. These data suggest that there is no one optimal living environment for frail older people and that traditional long-term care environments may be preferable for some.

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.