scholarly journals Measuring Childlessness Among Middle-Aged and Older Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 25-25
Author(s):  
Xiao Xu ◽  
Jersey Liang ◽  
BoRin Kim ◽  
James Raymo ◽  
Mary Beth Ofstedal
Keyword(s):  
High School ◽  
Similar Proportion ◽  
Middle Aged ◽  
Care Needs ◽  
Term Care ◽  
Older Americans ◽  
Biological Children ◽  
Nationally Representative ◽  
Complex Sample Design

Abstract Existing literature on childlessness among middle-aged and older Americans is sparse, and measuring childlessness is not straightforward for those with complex family histories. To address this knowledge gap, we examined data on 19,929 respondents age ≥50 from the 2016 Health and Retirement Study. All analyses accounted for complex sample design to generate nationally representative estimates. The proportion of respondents without children differed significantly depending on how “childless” was defined: 1) 14.9% (95% confidence interval [CI]: 13.9-15.9%) having no biological children, versus 2) 10.4% (95% CI: 9.5-11.3%) having no children/step-children that were living and in-contact. When measured based on absence of biological children, the prevalence of childlessness was higher in younger cohorts (17.7%, 13.2%, and 9.0% for age 50-64, 65-74, and ≥75 years, respectively, p<0.001) and among more educated individuals (17.4%, 12.3%, and 9.6% for more than high school, high school, and less than high school education, respectively, p<0.001). The prevalence of childlessness was also higher among men (16.7%) than women (13.2%) (p<0.001) and among non-Hispanic whites (16.0%) than Hispanics (9.8%) (p<0.001). Similar patterns, but lower prevalence, were observed when measuring childlessness based on absence of children/step-children that were living and in-contact. Although non-Hispanic whites (16.0%) were more likely than non-Hispanic blacks (13.0%) to have no biological children (p=0.007), a similar proportion of them had no children/step-children that were living and in-contact (10.8% versus 10.6%, p=0.06). Given fertility decline and growing family complexity, these findings help inform the structure of social support and long-term care needs of middle-aged and older Americans.

scholarly journals CHARACTERISTICS AND LIVING ARRANGEMENTS OF CHILDLESS ELDERLY AMERICANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S253-S254
Author(s):  
Xiao Xu ◽  
Jersey Liang ◽  
BoRin Kim ◽  
Mary Beth Ofstedal ◽  
James Raymo
Keyword(s):  
Living Arrangements ◽  
College Education ◽  
The Elderly ◽  
Care Needs ◽  
Term Care ◽  
Biological Children ◽  
Nationally Representative ◽  
Cognitively Intact ◽  
Complex Sample Design

Abstract Despite a growing number of Americans without children, information on characteristics of childless older adults and their living arrangements is sparse and often outdated. To address this knowledge gap, we examined data from the 2014 Health and Retirement Study (HRS) on childless Americans age ≥65 years (N=760) and compared with childless elders in 2004 HRS (N=830). All analyses accounted for complex sample design of HRS to generate nationally representative estimates. The proportion of elderly Americans without any living biological or step children increased from 8.1% in 2004 to 9.4% in 2014. Compared to childless elders in 2004, those in 2014 were younger (mean age=76.8 years versus 73.8 years, p<0.01) with a higher proportion completing college education (20.7% versus 37.5%, p<0.01) or were cognitively intact (64.6% versus 73.6%, p<0.01). However, childless elders in 2014 had more chronic conditions than those in 2004 (mean=2.5 versus 2.3, p<0.01). The proportion of childless elders living independently (alone or with a spouse) (81.6% in 2004 versus 82.6% in 2014) or living with others (10.0% in 2004 versus 13.5% in 2014) remained relatively stable, whereas the proportion living in nursing homes declined significantly from 8.4% in 2004 to 4.0% in 2014 (adjusted odds ratio [OR]=0.07, p<0.01). A sensitivity analysis limited to childless elders without biological children showed that they accounted for 9.9% of the elderly population in 2004 versus 11.9% in 2014, while other results were generally similar. These findings can help inform long term care needs of childless elders.

Health Literacy and Long-Term Care Needs among Thai Elderly in Rural Communities

2020 ◽  
Vol 103 (12) ◽  
pp. 1315-1324
Keyword(s):  
Depressive Symptom ◽  
Health Literacy ◽  
Rural Communities ◽  
Long Term Care ◽  
Health Knowledge ◽  
Elderly Persons ◽  
Care Needs ◽  
Term Care ◽  
Study Results

Background: Factors related to long-term care needs have been studied widely, but there is limited research about the influence of health literacy on long-term care needs among the elderly in rural communities where the social context and care environment are uniquely different. Objective: To examine factors influencing long-term care needs among Thai elderly in rural communities. Materials and Methods: The present study used the cross-sectional design. The study sample included 477 elderly persons, who were members of the communities in Nakhon Ratchasima Province. Multi-stage random sampling was used to select participants. They were interviewed using the demographic and health information questionnaire, the Thai Geriatric Depression Scale (TGDS), the health literacy scale of Thai adults and long-term care needs questionnaire. The selected factors examined as independent variables included some demographic factors, depressive symptom, and health literacy. Results: The present study results revealed significant positive relationships existing between long-term care needs with age and depressive symptom, while negative relationships between income and health literacy were reported. A hierarchical multiple regression analysis indicated that four of nine determinants of long-term care needs: age, depressive symptom, health knowledge and understanding, and ability managing their health condition significantly predicted long-term care needs at a level of 18% (R² adjusted=0.18, p<0.001). Conclusion: The present study results showed associations between personal and health literacy factors with long-term care needs. These findings prove that it is vitally important for healthcare professionals to consider the rural elderly’s mental health status and health literacy when providing care and planning treatment. Keywords: Health literacy, Long-term care needs, Rural community

scholarly journals Adopt, adapt, or abandon technology-supported person-centred care initiatives: healthcare providers’ beliefs matter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Dyb ◽  
Gro Rosvold Berntsen ◽  
Lisbeth Kvam
Keyword(s):  
Information Technologies ◽  
Scale Up ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Analytical Framework ◽  
Development Project ◽  
Technology Support ◽  
Care Needs ◽  
Term Care

Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.

scholarly journals Socioeconomic Status and Long-Term Care Provision to Parents in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 725-725
Author(s):  
Yoko Ibuka ◽  
Yui Ohtsu
Keyword(s):  
Socioeconomic Status ◽  
Long Term Care ◽  
Living Condition ◽  
Care Provision ◽  
Burden Of Care ◽  
Care Needs ◽  
Term Care ◽  
Japanese Adults ◽  
The Relationship

Abstract Socioeconomic status (SES) is generating considerable interest in terms of health of individuals, but how it is associated with long-term care has not been established yet. We study the relationship between SES and long-term care provision to parents among the Japanese adults using JSTAR. We use the following six measures of SES for the analysis: income, asset, expenditure, living condition, housing condition and education. We find a greater probability of care provision to parents among those in higher SES categories for some SES measures, compared to the lowest category. However, after considering the survival probability of parents, the relationship is reversed and the probability of care provision is found to be greater among lower SES individuals. The association is more pronounced among males. The association is likely to be partly mediated by care needs of parents. These results suggest a higher burden of care disproportionately falls in low SES individuals.

scholarly journals Title I: Modernizing Definitions and Programs Under the Administration on Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 714-715
Author(s):  
Marie Gualtieri
Keyword(s):  
Title I ◽  
Adult Population ◽  
Term Care ◽  
Older Americans ◽  
Aging Society ◽  
Program Adaptation ◽  
Older Americans Act ◽  
The Individual ◽  
Older Adult Population

Abstract The recent reauthorization of the Older Americans Act adds language and definitions to current issues facing the aging population. Specifically, Title I includes definitions related to program adaptation and coordination, workforce and long-term care issues, nutrition and social isolation, as well as family caregivers. Different from the last authorization, these definitions span beyond the individual experience to include other entities impacted by an aging society, such as the workforce and families. Overall, the Title I reauthorization seeks to modernize policy to reflect the current influx of the older adult population and its consequences.

Prevalence and Correlates of Gray Market Use for Aging and Dementia Long-Term Care in the U.S

2021 ◽  
pp. 073346482110236
Author(s):  
Regina A. Shih ◽  
Esther M. Friedman ◽  
Emily K. Chen ◽  
Grace C. Whiting
Keyword(s):  
Rural Areas ◽  
Long Term Care ◽  
Term Care ◽  
Unpaid Care ◽  
Gray Market ◽  
Sociodemographic Correlates ◽  
Nationally Representative ◽  
National Prevalence ◽  
The U.S

Objectives To estimate the national prevalence and sociodemographic correlates of gray market utilization, consisting of paid providers who are unrelated to the recipient, not working for a regulated agency, and potentially unscreened and untrained, for aging and dementia-related long-term care. Methods We surveyed a nationally representative sample of 1,037 American Life Panel respondents aged 18 years and older. Results Nearly a third of Americans who arranged paid care sought gray market care for persons with dementia, and most (65%) combined it with unpaid care. Respondents who arranged gray market care had 66% lower odds of currently working, and those living in rural areas had an almost 5-times higher odds of arranging dementia gray market care. Discussion Gray market care represents a substantial proportion of paid, long-term care for older adults and may fill gaps in access to care.

scholarly journals LifePlanning: A Better Retirement Planning Option for Our Times

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 111-112
Author(s):  
Rajiv Nagaich ◽  
Carol Redfield ◽  
Ben Harvill
Keyword(s):  
Institutional Care ◽  
Integrated Approach ◽  
Retirement Planning ◽  
Practice Research ◽  
Care Needs ◽  
Term Care ◽  
Investment Returns ◽  
The Many ◽  
In The Beginning

Abstract Ten thousand turn 65 daily. Majority look forward to retiring in the beginning and then become afraid of outcomes they often hear about- dealing with institutional care, becoming a burden, or running out of money. This is not because retirees do not plan, but despite of having planned their entire life for retirement. Many employers provide financial retirement planning such as a 401K plan. Individuals have relied on employee benefit plans to ready themselves, yet few are “very confident” about it. Two-thirds of retirees say their most recent employers did “nothing” to help them transition into retirement; 16% are “not sure” what their employers did. Many may be overlooking important factors in their strategies. Among retirees who currently have a retirement strategy, 85% have factored Social Security and Medicare benefits into their strategy. Most have included on-going living expenses (79%), total savings and income needs (57%) into their plan. Fewer than half have considered other critical factors (e.g., investment returns, ongoing healthcare costs, inflation, long-term care needs, tax planning, etc.). Only 9% have contingency plans for retiring sooner than expected and/or savings shortfalls. The truth is that education offered by employers tends to be traditional planning advice, which may not be enough to address the concerns retirees will have in retirement. To this, we introduce a multi-disciplinary LifePlanning Framework which takes a wholistic, integrated approach in addressing the many complex issues of retirement found in health, housing, finance, legal, and family. Our results may impact future practice, research, and policy.

“Then They Trust You …”

2017 ◽  
Vol 27 (2) ◽  
pp. 225-245 ◽  
Author(s):  
Marsha Love ◽  
Felipe Tendick-Matesanz ◽  
Jane Thomason ◽  
Davine Carter ◽  
Myra Glassman ◽  
...  
Keyword(s):  
Home Care ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Team Members ◽  
Physical Independence ◽  
Care Workers ◽  
Communications Skills ◽  
Home Care Workers

The home care workforce, already at 2.7 million caregivers, will become the nation’s fastest growing occupation by 2024 as the senior boom generation accelerates the demand for in home services to meet its long-term care needs. The physically challenging work of assisting clients with intimate, essential acts of daily living places home care workers (HCWs) at risk for musculoskeletal disorders (MSDs); yet, HCWs typically receive little formal job training and may lack appropriate assistive devices. In this qualitative pilot study, HCW focus groups described workplace MSD risk factors and identified problem-solving strategies to improve ergonomic conditions. The results revealed that HCWs rely on their behavioral insights, self-styled communications skills and caring demeanor to navigate MSD risks to themselves and increase clients’ physical independence of movement. We suggest changes in employer and government policies to acknowledge HCWs as valued team members in long-term care and to enhance their effectiveness as caregivers.

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