Loneliness, age at immigration, family relationships, and depression among older immigrants: A moderated relationship

Guided by a convoy model of social relations, this study explores the complex relationships between loneliness, age at immigration, familial relationships, and depressive symptoms among older immigrants. This study used 2010 Health and Retirement Study data from a sample of 575 immigrants (52% female, age range 65–99 years). Ordinary least squares regression models were estimated. The findings indicate that for older immigrants who came to the United States at age 45 or older, loneliness was significantly positively associated with depressive symptoms. Further, perceived negative strain and hours spent helping family moderated this relationship such that the effect of loneliness on depressive symptoms was stronger among respondents who perceived more negative family strain and spent fewer hours helping family. Familial relationships are crucial for the psychological well-being of older immigrants because they can be a source of either stress or support. The results have implications for how research and practices can support the immigrant families.

Health Risks Posed by Social and Linguistic Isolation in Older Korean Americans

Guided by the double jeopardy hypothesis, the present study examined the health risks posed by the coexistence of social and linguistic isolation in older Korean Americans. Using data from the Study of Older Korean Americans (SOKA, n = 2,032), comparisons of four isolation typologies (no isolation, social isolation only, linguistic isolation only, and dual isolation) were made, and their impacts on physical (self-rated health), mental (mental distress), and cognitive health (cognitive performance) were examined. The ‘dual isolation’ group exhibited greater sociodemographic and health disadvantages. The odds of having fair/poor health, mental distress, and cognitive impairment were 2.21-3.17 times higher in the ‘dual isolation’ group than those in the group with no isolation. Our findings confirm that both social relationships and language proficiency are key elements for older immigrants’ social connectedness and integration, deprivation of which puts them at risk in multidimensions of health.

Loneliness, Stress, and Depressive Symptoms Among Older Immigrants: A Moderating Role of Familial Relationships

Objectives Immigration is a stressful life event, and immigrants commonly experience loneliness, a risk factor for depression. However, little is known about how and whether older immigrants’ perceived stress exposure/appraisals mediate the association between loneliness and depressive symptoms. Further, this study explores whether familial relationships moderate the indirect or direct effects of the mediation models. Method: This study uses the 2012 Health and Retirement Study from a sample of 719 immigrants age 57 and older. A series of moderated mediation analyses were conducted across the total number of stress exposure and eight stress appraisal domains. Results The findings indicate that the total number of stress exposure and five domains of stress appraisals (health problems in self, physical/emotional problems in spouse/child, financial strain, housing problems, and close relationships in others) mediate the association between loneliness and depressive symptoms. In addition, the perceived negative strain from family moderated the mediating effect of health problems and housing problems in the relationship between loneliness and depressive symptoms. Discussion This study suggests that negative relationships with family may increase upsetting in stress appraisals on health and housing problems, which turn in increased depressive symptoms for lonely older immigrants. Practitioners need to assess older immigrants’ stressors and family relationships to understand their loneliness and depressive symptoms.

Preferences of Older Immigrants in Nursing Care: A Scoping Review

Background Worldwide, our societies are characterized by an increasing diversity, greatly contributed by immigrants. When in need of care older immigrants face various barriers and serious challenges in terms of unmet preferences. To provide person-centered care, health care professionals need to consider the personal background of immigrants to identify and assess their individual preferences. Objective To understand how preferences of older immigrants in nursing care are defined and how they can be assessed. Methods A scoping review will be conducted to identify and analyze preferences of older immigrants across health care settings. Preliminary results The literature search revealed that older immigrants in need of care define their preferences in terms of expectations and priorities. Differences among immigrants are related to the age of the person at the time of immigration, on cultural differences and/or on how the concepts of preferences in the country of origin is understood.

Activity Engagement Patterns Among Older Chinese Immigrants

Activity engagement is a major component of well-being in later life. However, very few studies have focused on older immigrants who are often at risk for social isolation and psychological distress. We aim to map the pattern of activity engagement and examine its variations in relation to immigration-related factors and social aspects of neighborhoods in a representative sample of older Chinese immigrants. We used data from the Population Study of Chinese Elderly in Chicago (PINE), a population-based epidemiological study of US Chinese older adults that were conducted between 2011 and 2013 (N=3,157). Latent class analysis and multinominal regression analysis were conducted to identify activity engagement patterns and examine the associated factors. Four patterns of activity engagement were identified: restricted (15%), diverse (31%), informal social (32%), and community-based social (21%). Acculturation and family-oriented immigration differentiated the restricted from the diverse class membership. Positive attributes of social environment measured by social network size, positive social support, neighborhood cohesion, and sense of community were associated with the probabilities of class membership relative to the restricted class. Findings point to the importance of positive attributes of social environment in enhancing engagement with life among older Chinese immigrants. Efforts are needed to assist the vulnerable restricted group and recent older immigrants while meeting the demands of older immigrants who are less educated and less acculturated. Creating a supportive environment is important to provide information, access, and resources needed for activity engagement in the marginalized minority aging populations

An Ecological Model of Risk Factors in Older Adults With Repeated Exposure to Elder Mistreatment

Limited empirical studies examined the factors related to repeated EM exposures among Chinese older immigrants. Guided by the ecological model, this study aims to explore what are the risk factors leading to recurrence of EM. Data were drawn from the two-wave PINE Study with 725 participants having EM at baseline and 191 reported repeated EM after two years. EM was evaluated by a 66-item instrument, including psychological, physical, and sexual mistreatment, financial exploitation, and caregiver neglect. Logistic regression was used. Increasing financial independence was associated with lower possibility of repeated EM (OR: 0.72, 95%CI 0.56-0.92). Every one unit increase in ADL impairment (OR: 1.10, 95%CI 1.02-1.18), IADL impairment (OR: 1.09, 95%CI 1.05-1.13) and increase frequency of alcohol consumption (OR: 1.33, 95%CI 1.06-1.66) were associated with higher possibility of repeated EM. Social service could improve physical function, provide financial support, and reduce health-risk behavior to prevent the recurrence of EM.

Variety of Identifying and Assessing Preferences of Everyday Living of Older Adults

Identifying preference of older adults supports person-centred care. The most sophisticated instrument is the preference for everyday living inventory (PELI). The PELI has been translated into German language and tested in different care settings. For people who experience difficulties communicating their preference the PELI has been combined with photographs. The voice of older immigrants could lead to an enhancement of the PELI as well other preference tools. Thus, our symposium title: Variety of identifying and assessing preferences of everyday living of older adults. Our symposium includes four presentations: Dr. Bergmann will present data from a preference study in three different care settings (long-term care, nursing homes, adult day care) in Germany. The results indicate that the importance of certain preferences distinguishes between the care settings. Dr. Vanessa Burshnic will present data from her content validity study of photographs used to supplement the Preferences for Everyday Living Inventory-Nursing Home (PELI-NH) from the perspective of older adults. Content analysis revealed thematic codes describing participants’ photograph preferences including image quality, context, subject diversity, and relevance to long-term care. Mike Rommerskirch-Manietta will present results from a review to identify Instruments which can be used to assess preferences for everyday living of older adults. Interestingly instruments either represent multiple or only one domain. The study from Viktoria Peters-Nehrenheim does focus on preferences of older immigrants. She will present results how older immigrants (first generation) define preferences and how they can be assessed. Prof. Van Haitsma will be our discussant.

Is Living in an Ethnic Enclave Associated With Better Cognitive Health of Older Immigrants? Results From PINE

This study addressed three questions: 1) Is living in Chinatown associated with better cognition among Chinese older immigrants? 2) Is the association moderated by education, acculturation level, and social engagement? 3) Does the association vary by preferred language (Mandarin, Cantonese, Taishanese), an important indicator of heterogeneity among Chinese immigrants? Data were derived from the Population Study of Chinese Elderly in Chicago (N = 3,055). Results showed that Chinese older immigrants who lived in Chinatown had significantly poorer cognition than those who didn’t, and such a difference was largely due to educational differences between the two groups. Higher education or acculturation buffered the influence of Chinatown residence on cognitive health, but only among those who speak Mandarin. The findings indicate that living in an ethnic enclave may have a negative impact on cognitive function of Chinese older immigrants. The findings also reveal the sources of heterogeneity within the population.

Cultural Differences in Older Immigrants' Health and Social Services Use

Even though Germany has a mandatory health and long-term care insurance with no or only very low co-payments, immigrants and the native population differ in their health and social services use. Differences in cultural traits and a lack of knowledge about the institutional setting are frequently mentioned as contributing factors. Relying on the epidemiological approach in the economic literature, this empirical study shows that both cultural traits that prevail in older immigrants’ country of origin and older immigrants’ knowledge about the host country’s institutional setting affect their health and social services use in Germany. We distinguish foreign-born immigrants and their descendants as both groups differ in their connection to the home and the host country. The results will be used to discuss immigrants’ access and potential barriers to the use of health and social services in comparison to the native population.