Nancy R. Hooyman

Creating a Vision for the Future: Key Competencies and Strategies for Culturally Competent Practice With Lesbian, Gay, Bisexual, and Transgender (LGBT) Older Adults in the Health and Human Services

Sexual orientation and gender identity are not commonly addressed in health and human service delivery, or in educational degree programs. Based on findings from Caring and Aging with Pride: The National Health, Aging and Sexuality Study (CAP), the first national federally-funded research project on LGBT health and aging, this article outlines 10 core competencies and aligns them with specific strategies to improve professional practice and service development to promote the well-being of LGBT older adults and their families. The articulation of key competencies is needed to provide a blueprint for action for addressing the growing needs of LGBT older adults, their families, and their communities.

Creating aging-enriched social work education

Summary The CSWE Geriatric Enrichment in Social Work Education Project, funded by the John A. Hartford foundation, aimed to change curricula and organizational structure in 67 GeroRich projects so that all students would graduate with foundation knowledge and skills to work effectively with older adults and their families. The emphasis was on change processes to infuse and sustain gerontological competencies and curricular resources in foundation courses. This article presents lessons learned and strategies for engaging faculty, practitioners and students in the curriculum and organizational change process.

Feminist Gerontology and the Life Course

Abstract Feminist gerontology is grounded in feminist theory and critical gerontology and focuses on power relations and intersecting oppressions across the life course. Analyses that incorporate a feminist perspective broaden our understanding of aging, moving beyond a singular focus on gender to a broader focus on multiple aspects of diversity, including privilege, inequality, and interdependence. In this article, we identify and discuss the central tenets of a feminist gerontological perspective, focusing on the lives of aging women in terms of research and policy issues regarding caregiving, work, and retirement. We suggest alternative and expanded research and teaching methods that counter feminist blind spots on age, as well as gerontologys blind spots where older women are concerned.

Reducing Poverty Among Older Women: Social Security Reform and Gender Equity

The authors document the higher poverty rate of older women, especially women of color, compared with older men—a pattern created and maintained by the intersection of the structural factors of age, race, and marital status. They then review how the U.S. Social Security program generally benefits older women and reduces their late-life economic vulnerability. A persistent gender inequity, however, is that women are more likely to disrupt their paid employment to meet family care responsibilities, which may increase the number of zero-earnings years and reduce the amount paid into Social Security. Current proposals to privatize the Social Security system are critiqued in terms of their gender inequities. Three relatively revenue-neutral proposals that could increase Social Securitys protection against poverty and differentially affect low-income women are briefly discussed.

Nonpharmacological Pain Management by Ethnically Diverse Older Adults With Chronic Pain: Barriers and Facilitators

As key players in multidisciplinary health care systems, geriatric social workers must understand the dynamics of pain management among older adults with chronic pain. This study identified perceived barriers to, and facilitators for, utilizing nonpharmacological pain management through face-to-face interviews with 44 ethnically diverse community-dwelling older adults. Constant comparative analysis identified barriers not recognized in prior studies: (a) embarrassment/self-consciousness, (b) unavailability of certain treatments, and (c) lack of faith in effectiveness of nonpharmacological treatments. Most frequently reported facilitators were (a) social support, (b) positive attitude, and (c) available resources. Social workers can provide counseling to motivate older adults to exercise to manage chronic pain and refer them to exercise programs tailored for older adults. To resolve the most frequently reported barrier—transportation—social workers can link older adults with transportation services offered by senior centers or other nonprofit agencies.

Multigenerational Practice: An Innovative Infusion Approach.

This article examines the impact of a curricular infusion strategy to integrate multigenerational practice issues into social work education. Based on a survey of MSW students (N=83), findings illustrate that student interest, knowledge, and skills in aging and multigenerational practice increased significantly following the implementation of a 3-tiered infusion approach. While the majority of students endorsed aging and multigenerational issues as important to social work in general, many did not understand the relevance to their own careers. In general, students were more interested in multigenerational rather than gerontological practice, both in relation to acquiring additional knowledge and skills and in pursuing further coursework. Next steps are outlined for integrating a multigenerational practice perspective into social work education.

Caregiving research, services, and policies in historically marginalized communities

Abstract Future research, service interventions and policies must be responsive to the changing context of caregiving in this country and the increasing diversity in our society at large. This article examines the conceptual and methodological limitations that are inherent in the ma—jority of the caregiving literature and outlines directions for future work on caregiving in marginalized communities, with a special emphasis on sexual orientation and gender identity. The article illustrates the impor—tance of cultural variations and multiple identities as they relate to care—giving across diverse communities and explores ways to increase both theoretical and methodological rigor in future studies as well as ways to effectively access relatively hard to reach populations. As we move for—ward in caregiving research, services and policies, there is a critical need for increased attention to the societal context in which caregiving occurs—especially if we are to understand the realities of caregiving across marginalized and diverse communities.

Factor Structure of the Arthritis-Related Health Belief Instrument in Ethnically Diverse Community-Dwelling Older Adults with Chronic Pain

Nonpharmacological treatment of chronic pain in older people can be effective but attitudes and adherence to use of this treatment may differ by ethnicity. This study supports that a modified 14-item instrument based on the modified Health Belief Model—the arthritis-related health belief instrument (AHBI)—can be used across ethnically diverse older adults (i.e., European Americans, Hispanics, African Americans, and Afro-Caribbeans). Confirmatory factor analysis tested the factor structure of the AHBI to eliminate items inappropriate for this population. Structural equation modeling tested expected relationships among four latent variables—severity, susceptibility, barriers, and benefits—across the four ethnic groups. Findings suggest that the modified 14-item AHBI (eliminating two items from the original AHBI) adequately described the four latent factors pertaining to use of nonpharmacological pain therapy in this sample. All items registered substantial loadings (.41–.95) on the hypothesized factors, operating similarly across the four ethnic groups. The modified 14-item AHBI may be useful in (a) assessing how individual perceptions influence access to nonpharmacological pain therapy among ethnically diverse community-dwelling older adults, with the goal to develop and implement effective pain treatment for this population; and (b) measuring the likelihood of using nonpharmacological pain therapy by older adults. The modified 14-item AHBI can help health care providers to provide accurate pain assessment and examine domains that could affect use of nonpharmacological pain therapy by ethnically diverse older adults and guide practice with them by identifying barriers to use of such therapies and providing education to encourage their use.

Association of Socio-Demographic Factors and Parental Education With Depressive Symptoms Among Older African Americans and Caribbean Blacks

Objective: The purpose of this study was to examine ethnic variation in the relationship between individual socio-demographic factors, parental educational level, and late-life depressive symptoms in older African Americans and Caribbean Blacks. Method: This cross-sectional study used data from the National Survey of American Life. A subsample of older African Americans (N = 837) and Caribbean Blacks (N = 271) was analyzed using multiple regression analysis. Results: Findings suggest differences in predictors of depressive symptoms for the two ethnic groups. Among older African Americans, lower educational attainment and lower income were predictive risk factors for higher depressive symptoms. Findings among older Caribbean Blacks suggest that nativity and income were significantly associated with depressive symptoms. This study did not find support for any association between parental education and late-life depressive symptoms. Conclusion: This study adds new information by considering ethnic variation in an examination of depressive symptoms in older Black Americans. The results contribute to the growing awareness of the older Caribbean Black population in the United States.

Mutual Help Organizations for Rural Older Women.

The effects of older age, womens roles, and some aspects of rural life, singly or in combination, can jeopardize rural older womens well‐being. The disproportionate risks to well‐being experienced by rural older women are the motivation for and the focus of the development of a mutual help model. A mutual help organization cannot be a solution to all problems, but it can be conceived of as one element within the care continuum of rural older women. The purposes of this paper are: (1) to describe some of the problems and needs of rural older women, (2) to propose mutual help organizations as one way of meeting their needs, (3) to suggest factors and techniques for the development and evaluation of a mutual help model for rural older women, and (4) to identify the educational implications of this approach for working with the rural elderly.