Inequalities of Aging

2018 ◽  
Author(s):  
Elana D. Buch
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Population Policy ◽  
Quality Care ◽  
The United States ◽  
Turnover Rates ◽  
High Turnover ◽  
Social Challenges ◽  
Care Workers ◽  
Institutional Contexts

Paid home care sits at the nexus of two of the United States’ biggest social challenges: rising inequality and an aging population. Policy and advocacy initiatives typically treat poverty and care of the aged as distinct forms of vulnerability. They are seen as having separate social causes that require different solutions. Using rich ethnographic narrative based on fieldwork in Chicago, this book examines the diverse relationships generated by care and their connections to longer national histories, policies, and institutional contexts. The vulnerabilities of older adults and care workers are commingled: low wages and poor working conditions render workers’ lives precarious. In turn, high turnover rates and endemic worker shortages translate into wait lists and lower quality care for older adults. In home care, the fate of older adults and the working poor are bound together, entangled by the broader indifference of a society that devalues both aging and care.

Care Falls Apart

2018 ◽  
pp. 176-200
Author(s):  
Elana D. Buch
Keyword(s):  
United States ◽  
Older Adults ◽  
Public Policy ◽  
Home Care ◽  
Job Loss ◽  
Family Care ◽  
The United States ◽  
High Turnover ◽  
Care Workers

Across the United States, home care faces perpetual worker shortages and endemically high turnover levels estimated at between 60% and 90% per year. This chapter examines cases of turnover in rich ethnographic detail, arguing that the inability of agency and public policy to recognize the interdependence of older adults, workers, and their families contributes to this startling statistic. In observed cases of turnover; job loss stemmed from workers’ inabilities to sustain both their own households and those of their older adults without blurring the boundaries between them. Workers lost jobs because of conflicts with family care and because they engaged in unsanctioned reciprocities with clients. Current attempts to protect vulnerable older adults from possible exploitation actually exacerbate the exploitation of care workers and increase instability in home care.

scholarly journals Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services

2017 ◽  
Vol 15 (1) ◽  
pp. 20-26
Author(s):  
Guillermina R. Solis ◽  
Jane Dimmitt Champion
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Home Health Care ◽  
Fall Risk ◽  
Health Care Services ◽  
Home Care Services ◽  
Recurrence Risk ◽  
The United States ◽  
Care Services ◽  
Risk Of Fall

Introduction: Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person’s quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. Method: A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. Results: A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Conclusion: Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

A Lack of Reciprocity

2019 ◽  
pp. 203-238
Author(s):  
Cati Coe
Keyword(s):  
United States ◽  
Health Insurance ◽  
Home Care ◽  
The United States ◽  
Domestic Service ◽  
National Belonging ◽  
Workplace Conditions ◽  
Care Workers ◽  
State Of Affairs ◽  
Service Agencies

This chapter examines how workplace conditions and benefits shape care workers’ national belonging. It discusses the home care field, including its historically unregulated character due to its categorization as domestic service. Agencies are currently responding to new regulations regarding overtime and health insurance, which have had contradictory effects on workers. It also discusses the amount of profit agencies are making from care workers. Care workers feel that they are denied reciprocities to which they are entitled through their labor. This is thus a complicated sense of belonging, in which they belong enough to feel entitled to reward, but not enough belonging to feel that they can work in unison against this system. Many, instead, decide that this state of affairs confirms that they belong in their home countries rather than in the United States. It is there that they imagine that they will reap the rewards of their labor and attain a dignity that is denied in the United States.

scholarly journals Meeting Geriatric Competencies: Are Internal Medicine Residency Programs in New Jersey Meeting Expectations for Quality Care in Older Adults

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401982767
Author(s):  
Ramy Sedhom ◽  
Daniel Sedhom ◽  
David Barile
Keyword(s):  
Internal Medicine ◽  
Older Adults ◽  
New Jersey ◽  
Palliative Medicine ◽  
Training Programs ◽  
Quality Care ◽  
The United States ◽  
Outpatient Setting ◽  
Older Individuals ◽  
Formal Curriculum

There has long been recognition for improved education and training in aging and geriatrics. As the number of older individuals in the United States increases, with 20% being older than 65 years by 2030, it will become increasingly important for internists and medical subspecialty trainees to have proper training in the care of older adults. A survey was developed and administered to Internal Medicine Program Directors, to perform an educational needs assessment. The survey was administered during the beginning of the 2015 academic year via email. The survey assessed general program characteristics, details regarding required geriatric and palliative medicine teaching, opportunities for electives, barriers encountered at each training site, and future recommendations for improving the structure of resident education. Analysis of survey responses indicated that geriatric and palliative care education is lacking. Although all training programs provided some aspect of geriatric and palliative medicine training to internal medicine residents, only 27% of training programs had a formal curriculum in geriatric and palliative medicine. The majority had an informal curriculum. Very few programs reported using a multimodality approach; most used isolated experiences in either an inpatient or an outpatient setting. Although all residency directors believed curricular developments in geriatric and palliative medicine were important, very few have available faculty needed to facilitate curricular improvements. Almost all identified that they would use a restructured curriculum if it were readily available. Investment in developing content and a standardized curriculum in geriatric and palliative medicine would be very valuable and well received in New Jersey.

Social Workers’ Attempts to Navigate Among the Elderly, Their Families, and Foreign Home Care Workers in the Haredi Community

2017 ◽  
Vol 38 (5) ◽  
pp. 617-638 ◽  
Author(s):  
Anat Freund ◽  
Tova Band-Winterstein
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Social Workers ◽  
The Elderly ◽  
Phenomenological Approach ◽  
Care Workers ◽  
Barriers And Challenges ◽  
Qualitative Phenomenological ◽  
Cultural Bridge ◽  
Home Care Workers

Background: The study’s aim is to examine social workers’ experience in facilitating the integration of foreign home care workers (FHCWs) into the ultraorthodox Jewish (UOJ) community for the purpose of treating older adults. Method: Using the qualitative-phenomenological approach, semistructured, in-depth interviews were conducted with 18 social workers in daily contact with UOJ older adult clients in the process of integrating FHCWs. Results: Data analysis revealed three central themes—integrating FHCWs into the aging UOJ family: barriers and challenges in the interaction between the two worlds; “even the rabbi has a FHCW”: changing trends in caring for older adults; and the social worker as mediator and facilitator of a successful relationship. Discussion: Social workers play a central role, serving as a cultural bridge in the process of integrating FHCWs, as a way of addressing the needs of ultraorthodox elderly and their families, while also considering the needs of the foreign workers.

scholarly journals HOME AND COMMUNITY-BASED CARE FOR A DIVERSE AND GROWING POPULATION: WORKFORCE POLICY AND PRACTICE IMPLICATIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S441-S441
Author(s):  
Kezia Scales ◽  
Jodi M Sturgeon ◽  
Lisa I Iezzoni ◽  
Robert Espinoza ◽  
Stephen Campbell ◽  
...  
Keyword(s):  
Home Care ◽  
Supply And Demand ◽  
The United States ◽  
Key Factors ◽  
Policy And Practice ◽  
Community Based ◽  
Financing Policies ◽  
Care Workers ◽  
Workforce Policy ◽  
Home Care Workers

Abstract Most Americans would prefer to continue living in their homes and communities as they age, even when they require support with daily activities due to illness or disability. Much of this support is provided by unpaid caregivers, but the paid home care workforce also plays an essential role. Due to demographic changes and poor job quality, however, the home and community-based services (HCBS) sector is struggling to attract and retain enough workers to meet demand. Drawing from an extensive analysis of HCBS in the United States, this paper examines key factors impacting the home care workforce, including: supply and demand trends; financing policies; service-delivery models; and policies and practices defining workers’ compensation, training, and career development. From these findings, we provide recommendations for addressing the home care workforce crisis and maximizing home care workers’ contribution to the delivery of high-quality supports for a growing and evolving population of HCBS consumers.

Model of Welfare Capitalism? The United States Rubber Company in Southeast Asia, 1910–1942

2007 ◽  
Vol 8 (1) ◽  
pp. 136-174
Author(s):  
Shakila Yacob
Keyword(s):  
United States ◽  
Southeast Asia ◽  
The United States ◽  
Profit Sharing ◽  
Pension Plans ◽  
American Business ◽  
Turnover Rates ◽  
Labor Costs ◽  
High Turnover ◽  
Welfare Capitalism

Welfare capitalism, the management ethos adopted by American business leaders in the early twentieth century, emphasizes the role of business rather than trade unions or government in taking care of its workers. This article focuses on the reasons why the United States Rubber Company (USRC), one of the four largest U.S. rubber manufacturers, promoted welfare capitalism at its rubber plantations on the east coast of Sumatra and Malaya between 1910 and 1942. In addition, this study assesses the development of USRC's system of welfare in the areas of housing, profit sharing, pension plans, health care, and recreation. This article argues that USRC's intention was not to forestall unionization (the intention of U.S.-based companies in adopting welfare capitalism), as union formation in Southeast Asia during that period was very unlikely, but to overcome labor shortages and high turnover rates and to ensure labor stability. With reduced labor costs, the availability of financial resources allowed for technical innovations and R & D, which ultimately would lead to increased productivity.

The High Price of Obesity in Nursing Homes

2015 ◽  
Vol 16 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Cindy L. Marihart ◽  
Ardith R. Brunt ◽  
Angela A. Geraci
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
The United States ◽  
Nursing Home Care ◽  
Health Concern ◽  
High Price ◽  
Obese Adults ◽  
Obese People

This article provides a commentary on the costs of obese nursing home patients. We conducted a comprehensive literature search, which found 46 relevant articles on obesity in older adults and effects on nursing home facilities. This review indicated obesity is increasing globally for all age groups and older adults are facing increased challenges with chronic diseases associated with obesity more than ever before. With medical advances comes greater life expectancy, but obese adults often experience more disabilities, which require nursing home care. In the United States, the prevalence of obesity in adults aged 60 years and older increased from 9.9 million (23.6%) to 22.2 million (37.0%) in 2010. Obese older adults are twice as likely to be admitted to a nursing home. Many obese adults have comorbidities such as Type 2 diabetes; patients with diabetes incurred 1 in every 4 nursing home days. Besides the costs of early entrance into nursing facilities, caring for obese residents is different than caring for nonobese residents. Obese residents have more care needs for additional equipment, supplies, and staff costs. Unlike emergency rooms and hospitals, nursing homes do not have federal requirements that require them to serve all patients. Currently, some nursing homes are not prepared to deal with very obese patients. This is a public health concern because there are more obese people than ever in history before and the future appears to have even a heavier generation moving forward. Policymakers need to become aware of this serious gap in nursing home care.

scholarly journals Affective Commitment to Organizations: A Comparison Study of Reverse Mentoring Versus Traditional Mentoring Among Millennials

2017 ◽  
Vol 8 (2) ◽  
pp. 157
Author(s):  
Catrin Hechl
Keyword(s):  
Affective Commitment ◽  
Online Survey ◽  
Average Length ◽  
The United States ◽  
Sample Population ◽  
Turnover Rates ◽  
High Turnover ◽  
Significant Difference ◽  
Traditional Mentoring ◽  
Quasi Experimental

A current topic of interest in management and organization research is the phenomenon of a generation shift in the workforce and how this shift will affect organizations in the near future.  Millennials represent the largest generational cohort in the American workforce.  Organizations find themselves challenged with retention efforts as Millennials tend to leave an organization after short tenures.  The problem this study addressed is the high turnover rates among millennial employees. Specifically, it was unknown whether Millennials who received reverse mentoring evidenced greater affective commitment to the organization as compared to Millennials who received standard mentoring.  The purpose of this study was to investigate the hypothesis that Millennials who received reverse mentoring evidenced greater affective commitment to the organization as compared to Millennials who received standard mentoring.  A two group post-test only quasi-experimental design was conducted.  A total of 90 participants (45 per group) completed the survey.  The survey was conducted by Qualtrics, an online survey company.  The sample population included male and female individuals, born between 1982 and 1998, employed by all types of organizations in the United States and participating in a mentoring program at the time the survey was taken.  Affective commitment was greater in the reverse mentoring group (M = 36.683, SE = .959) compared to the traditional mentoring group (M = 34.984, SE = .959).  However, after adjustment for quality of relationship (LMX) and length and frequency of mentoring (LFM) there was no statistically significant difference (p < .05) between traditional mentoring and reverse mentoring on affective commitment to the organization indicated by F(1,86) = 1.569, p = .214.  Additional results of this study showed that two-thirds of the surveyed millennial employees had already exceeded the average length of employment of 12 to 18 months with the organization they were employed with at the time of the survey.  This finding indicated the importance of investing in workplace relationships, such as mentoring, regardless of traditional or reverse.

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