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Older lesbians' experiences with home care: varying levels of disclosure and discrimination
- Author:
- BUTLER Sandra S.
- Journal article citation:
- Journal of Gay and Lesbian Social Services, 29(4), 2017, pp.378-398.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
There is considerable evidence that lesbian, gay, bisexual and transgender (LGBT) older adults have experienced barriers to health care access and have profound fears about how they will be treated in the long-term care system, but the specific experiences of older lesbians have received less attention. Most older adults needing long-term services and supports (LTSS) prefer to remain at home, and this is true for lesbians as well. This article reports on a national, qualitative study of the experiences of 20 older lesbians (age 65 and older) with home care workers. The experiences of six informal partner caregivers with home care services are also included. Emergent themes regarding level of disclosure, experiences with homophobia, evaluation of care received, and thoughts about ideal LTSS are described. Most study participants did not disclose their sexual orientation to their home care workers. A significant minority experienced homophobia, but nearly all ultimately found workers who provided good care with which they were comfortable. Their visions of ideal LTSS included greater affordability and particular qualities that were important for home care workers to possess, such as competence, caring and acceptance. Practice and policy implications are outlined including careful recruitment, training and supervision of home care workers to foster lesbian-sensitive care, but also improved wages and work conditions in order to maintain a quality home care workforce. (Publisher abstract)
Resilience in attaining and sustaining sobriety among older lesbians wth alcoholism
- Authors:
- ROWAN Noell L., BUTLER Sandra S.
- Journal article citation:
- Journal of Gerontological Social Work, 57(2-4), 2014, pp.176-197.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This phenomenological study illuminates coping among older lesbians with alcoholism. Twenty study participants were recruited through purposive and snowball sampling; each completed 3 interviews structured to gain a deeper understanding of participants’ lived experiences. This article focuses on the key situations and people that helped study participants obtain sobriety and stay sober. Five major themes emerged from the data: wake-up calls, impact of formal treatment, impact of 12-step recovery groups, consequences from other sources, and resiliency. Findings support the need for culturally sensitive approaches to practice with this subpopulation of older adults. (Publisher abstract)
Older women doing home care: exploitation or ideal job?
- Author:
- BUTLER Sandra S.
- Journal article citation:
- Journal of Gerontological Social Work, 56(4), 2013, pp.299-317.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study examined lifetime financial security and perceived advantages of older age in the field of home care through interviews with 31 older home care aides in the United States. Study participants experienced high levels of financial insecurity and perceived older workers as particularly well suited to the home care job. The consequences of this low-wage, low-status work are explored along with implications for social workers to advocate for improved conditions for these workers providing essential care to frail elders. (Edited publisher abstract)
Why do they leave? Factors associated with job termination among personal assistant workers in home care
- Authors:
- BUTLER Sandra S., et al
- Journal article citation:
- Journal of Gerontological Social Work, 53(8), November 2010, pp.665-681.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Recruiting and retaining an adequate number of personal support workers in home care is challenging; annual turnover rates of between 25 and 50% have been reported. This mixed-method, longitudinal study examined turnover in a sample of 261 personal support workers employed across eleven home care agencies in Maine. The 70 workers (26.8%) who left their employment in the first year of the study completed a second questionnaire on leaving and were interviewed by telephone. Younger age and lack of health insurance were significant predictors of turnover. The telephone interviews revealed three main themes around leaving the job: job not worthwhile, personal reasons, and burnout. The authors note that job termination by personal care workers was not simply based on a decrease in job satisfaction; many left despite continuing to love the work. Higher levels of emotional exhaustion and lower levels of personal accomplishment were common in the leaving, compared to the study start, survey. Many workers indicated that low pay made continuing in their job unsupportable. The authors discuss the implications of the study findings for gerontological social workers.
Evaluating the senior companion program: a mixed-method approach
- Author:
- BUTLER Sandra S.
- Journal article citation:
- Journal of Gerontological Social Work, 47(1/2), 2006, pp.45-70.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article reports on a mixed-method assessment of the Senior Companion Program (SCP), a federal program in the United States which provides volunteer opportunities with small stipends to low-income older adults, 60 years of age and older, who provide companionship and offer assistance to frail community elders. Through four standardized scales and open-ended questions regarding the impact of the SCP in their lives, 34 Senior Companion volunteers and 32 of their clients were interviewed. Informants reported relatively large social networks and low levels of depression and loneliness. Thematic analysis of the qualitative data revealed the benefits of the program for both volunteers and their clients. Themes emerging from the rich narratives included: companionship, independence, reduced anxiety, giving, and rewards. The article concludes with a suggested brief evaluation instrument that directors of SCP programs, and other similar programs, can use to collect data on the impact of their program-something that is required, but often difficult to do. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Depression and caregiver burden among rural elder caregivers
- Authors:
- BUTLER Sandra S., et al
- Journal article citation:
- Journal of Gerontological Social Work, 46(1), 2005, pp.47-63.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Through a simple screening tool, the Maine Primary Partners in Caring (MPPC) project identified individuals providing care to older adults through rural primary care practices, in order to provide “upstream interventions” before caregivers were in crisis. This paper describes a sample of 62 rural family caregivers identified through their physicians' offices. High levels of caregiver burden and depression were reported. Family support and knowledge of caregiver tasks predicted decreased caregiver burden and depression, while isolation predicted increased caregiver burden. Implications of these results for gerontological social workers are outlined. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Gay, lesbian, bisexual, and transgender (GLBT) elders: the challenges and resilience of this marginalized group
- Author:
- BUTLER Sandra S.
- Journal article citation:
- Journal of Human Behavior in the Social Environment, 9(3), 2004, pp.25-43.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Current gay, lesbian, bisexual, and transgender (GLBT) individuals age 65 years and older grew up before the Gay Rights movement. They have learned over many years to hide their identities in order to avoid discrimination and ridicule. Unfortunately, this secrecy has led to the near invisibility of the elder GLBT population and to poor health and service access. This paper reviews what we know about GLBT elders, describes some of the unique strengths they bring to the aging process, and outlines some of the challenges they face. Micro, mezzo, and macro practice implications are suggested. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Specialized housing and rural elders
- Authors:
- BUTLER Sandra S., SHARLAND Donald W.
- Journal article citation:
- Journal of Gerontological Social Work, 42(3/4), 2003, pp.247-263.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The article begins with an examination of current living arrangements and housing conditions among the elderly in general and for rural elders in particular. The environmental press and empowermentoriented practice models provide readers with a framework for understanding the underlying tension between autonomy and security faced by rural elders and the social workers who assist them. Drawing from in-depth interviews with nine geriatric social workers working with elders in rural housing settings, we explore practice challenges, particular issues related to rurality, and innovative techniques and programmes. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
Advocacy techniques with older adults in rural environments
- Authors:
- BUTLER Sandra S., WEBSTER Nancy M.
- Journal article citation:
- Journal of Gerontological Social Work, 41(1/2), 2003, pp.59-74.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Examines the role of advocacy and its implementation for gerontological social work practice in rural areas. Reviews some of the many ways social work advocacy has been defined over the years and specifically how advocacy can be used in social work practice with older adults. Particular attention is given to an advocacy model currently utilized in rural Maine-the Integrated Case Management model and how it is precisely well-suited to the needs of older people living in rural areas. Concludes with recommendations regarding the incorporation of advocacy into rural gerontological social work practice. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Raising our voices: a macro practice assignment
- Authors:
- BUTLER Sandra S., COLEMAN Patty A.
- Journal article citation:
- Journal of Teaching in Social Work, 15(1/2), 1997, pp.63-80.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Field placements rarely offer student opportunities to learn and practice large scale social change interventions. This article describes a classroom assignment, the Advocacy Project, which allows students to gain practical skills in large system change. Data collected through a survey instrument mailed to undergraduate and graduate students (n=48) who had completed the Advocacy Project sometime between 1995 and 1992 demonstrate the effectiveness of this exercise in increasing respondents' overall attention to macro practice tasks after graduation. As a result of the Advocacy Project, respondents reported: a new identification for successful problem resolution; feelings of increased confidence and personal empowerment; and a new awareness of the value of collective action by small groups.