Shulamit L. Bernard

The association of urinary incontinence with poor self-rated health

OBJECTIVES: To assess whether urinary incontinence (UI) and its severity are associated with poor self‐rated health in a national sample of community‐living older adults and whether this relationship persists after controlling for confounding attributable to functional status, comorbidity, and demographic factors.

Gender and ethnic differences in alternative and conventional arthritis remedy use among community‐dwelling rural adults with arthritis

OBJECTIVE To examine the frequency of, and the ethnic and gender differences in, the use of arthritis remedies among rural adults. METHODS Interviews were conducted with 219 adults from a nonmetropolitan North Carolina county. Participants reported whether they ever used and still used 19 remedies. Participants were evaluated for the actual presence of arthritis and functional capacity. Analysis included descriptive statistics and multivariate logistic regression. RESULTS Participants used a variety of alternative and conventional remedies, with prayer (92%) being most widely used. Prescription medicine was used by 60%. Differences in remedy use included European-Americans making greater use of conventional remedies and African-Americans making greater use of some alternative remedies. Those with greater functional disability have used alternative remedies, but they still used prescription medicine. CONCLUSIONS Rural individuals use a variety of remedies, with differences by gender, ethnicity, and functional capacity. Future research must examine the role of gender, culture, residence, and disease severity in arthritis remedy use decisions.

Self‐Care Practices Used by Older Men and Women to Manage Urinary Incontinence: Results from the National Follow‐up Survey on Self‐Care and Aging

OBJECTIVES: To estimate the extent to which self‐care practices are employed by older adults with urinary incontinence (UI); to determine how demographic and functional status measures are associated with self‐care practice use; and to explore the relationship between contacting a doctor and disposable pad use.

The Economic Implications of Self-Care: The Effect of Lifestyle, Functional Adaptations, and Medical Self-Care Among a National Sample of Medicare Beneficiaries

OBJECTIVES Self-care includes actions taken by individuals to promote or ensure their health, to recover from diseases or injuries, or to manage their effects. This study measured associations between self-care practices (lifestyle practices, adaptations to functional limitations, and medical self-care) and Medicare expenditures among a national sample of adults 65 years and older. METHODS Regression models of Medicare use and expenditures were estimated by using the National Survey of Self-Care and Aging and Medicare claims for 4 years following a baseline interview. RESULTS Lifestyle factors (swimming and walking) and functional adaptations (general home modifications) were associated with reductions in monthly Medicare expenditures over a 12-month follow-up period. Expenditure reductions were found over the 48-month follow-up period for participation in active sports, gardening, and medical self-care. Practices associated with increases in expenditures included smoking, physical exercise (possibly of a more strenuous nature), and specific home modifications. CONCLUSIONS Certain self-care practices appear to have significant implications for Medicare expenditures and presumptively for the health status of older adults. Such practices should be encouraged among older adults as a matter of national health policy.