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Comparison of depressive symptoms between homebound older adults and ambulatory older adults
- Authors:
- CHOI Namkee G., McDOUGALL Graham J.
- Journal article citation:
- Aging and Mental Health, 11(3), May 2007, pp.310-322.
- Publisher:
- Taylor and Francis
Due to the social isolation imposed by chronic illness and functional limitations, homebound older adults are more vulnerable to depression than their mobility-unimpaired peers. In this study, the authors compared 81 low-income homebound older adults, aged 60 and older, with their 130 ambulatory peers who attended senior centers, with respect to their depressive symptoms, depression risk and protective factors, and self-reported coping strategies. Even controlling for sociodemographics, health problems, and other life stressors, being homebound, as opposed to participating in senior centers, was significantly associated with higher depressive symptoms. However, when the coping resources-social support and engagement in frequent physical exercise, in particular-were added to the regression model, the homebound state was no longer a significant factor, showing that the coping resources buffered the effect of the homebound state on depressive symptoms. In terms of self-reported coping strategies, even among the depressed respondents, only a small proportion sought professional help, and that was largely limited to consulting their regular physician and social workers, who may not have had professional training in mental health interventions.
Barriers and contributors to minority older adults' access to mental health treatment: perceptions of geriatric mental health clinicians
- Authors:
- CHOI Namkee G., GONZALEZ John M.
- Journal article citation:
- Journal of Gerontological Social Work, 44(3/4), 2005, pp.115-135.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This exploratory study examined geriatric mental health clinicians' experiences and perceptions of the circumstances in which African American and Mexican American older adults access outpatient specialty mental health treatment and the factors that impede or facilitate such access. Eighteen mental health clinicians from three outpatient geriatric mental health clinics in one urban and two rural areas in central Texas discussed their perceptions in three focus groups and/or individual interviews conducted by the authors. The clinicians identified the common circumstances in which minority older adults' access to mental health treatment involves loss and grief in later life coupled with lack of informal social support. Although clinicians confirmed existence of the access barriers identified by previous studies (lack of understanding about mental disorders, shame and stigma, cultural differences, fear and distrust of the treatment system, primary care physicians' knowledge deficit about mental disorders, and financial and transportation barriers), they also identified minority older adults' lack of information on referral processes as a serious barrier. As access contributors, physician referral; support and encouragement from family, especially adult children; availability of bilingual/bicultural clinicians; and transportation were identified. Implications of the findings are also discussed.
Nonmarried aging parents' and their adult children's characteristics associated with transitions Into and out of intergenerational coresidence
- Author:
- CHOI Namkee G.
- Journal article citation:
- Journal of Gerontological Social Work, 40(3), 2003, pp.7-29.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Using data from the 1993-1995 waves of the Asset and Health Dynamics among the Oldest Old (AHEAD), this study focuses on analyzing elderly parents' and their children's characteristics associated with the transitions into and out of intergenerational coresidence. Multinomial logistic regression results show that transition into coresidence was primarily initiated by the parents' old age and deteriorating health and/or health-related crises. Transition out of coresidence into parents' institutionalization was also likely to have been triggered by the parents' health problems. In addition, other things being equal, divorced/separated or never-married parents were more likely but African American and Hispanic parents were less likely to have moved into an institution over a 2-year period. Children in the newly coresiding pairs and those of institutionalized parents were more likely to be married than children in the continuously coresiding pairs. The implications of these within-group differences for social work practice are discussed. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Changes in self-assessment of health: comparison of self-perception and self-ratings score measures among young-old persons
- Author:
- CHOI Namkee G.
- Journal article citation:
- Journal of Gerontological Social Work, 37(1), 2002, pp.65-88.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Most geriatric screening instruments include the self-ratings of health scale as a useful collateral source of information on elders' health status and their need for social and health services. In this article the author reviewed extant research findings on subjective assessment of health and then compared the congruence and discrepancybetween the commonly used self-ratings scale and the less frequently used self-perception scale as measures of longitudinal stability or changes in health status among the young-old. Analysis shows that the restricted range of the self-ratings scale poses a limitation when the scale is used to measure changes in health status over time. Itwas also found that the self-ratings scale may reflect a more horizontal, social- comparison dimension and that the self-perception measure may reflect a more vertical, temporal-comparison dimension in subjective assessment of longitudinalchanges in health status. Social workers need to be aware of the strengths and limitations of both measures when they use them.
Diversity within diversity: research and social work practice issues with Asian American elders
- Author:
- CHOI Namkee G.
- Journal article citation:
- Journal of Human Behavior in the Social Environment, 3(3/4), 2001, pp.301-319.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Asian American elderly form a heterogeneous group with respect to immigration history, ethnic/cultural background, socio economic position, and health and mental health status. This article provides an overview of the internal heterogeneity within the Asian American elderly population and identifies those who experience multiple stressors affecting their quality of life. Then it discusses barriers to formal service utilisation as well as strengths and deficits of informal support systems. To better serve Asian American elders with their multiple needs for health, mental health, and social services, increased funding is recommended for research on this group, diversification of social service programmes in coethnic communities, and increased cultural competence in non-Asian social service agencies.
Determinants of frail elders' lengths of stay in meals on wheels
- Author:
- CHOI Namkee G.
- Journal article citation:
- Gerontologist, 39(4), August 1999, pp.397-404.
- Publisher:
- Oxford University Press
Home-delivered meal programmes such as Meals on Wheels are low-cost, long-term care services that can contribute to a delay of institutionalisation and to the maintenance of self-sufficiency and quality of life among older people living in the community. This study analyses the reasons for elders' termination of Meals on Wheels and determinants of their lengths of stay on the programme. The analysis found that elders' health status, race and appetite are significantly associated with the hazard of elders' termination. Strategies to improve the acceptability of the services are discussed.
The relationship between social support and health status of elderly people: does social support slow down physical and functional deterioration?
- Authors:
- CHOI Namkee G., WODARSKI John S.
- Journal article citation:
- Social Work Research, 20(1), March 1996, pp.52-63.
- Publisher:
- Oxford University Press
Because the elderly population is increasing, both informal and formal support systems face an increasingly difficult task of providing eldercare. This article analyses a sample of elderly men and women in the United States of America to determine the elasticity of their informal social support systems in response to their declining health and the effects of such support on their health outcomes. Results indicate that the extent of informal support is more likely to be bound by the size of the social support network than by the demand for care associated with declining health. However, social support for elderly people tends to slow down further deterioration of their health, confirming the beneficial effect of social support on elderly people's health outcomes. Policy and practice implications are discussed.
Social work practice with the Asian American elderly
- Editor:
- CHOI Namkee G.
- Publisher:
- Haworth Social Work Practice Press
- Publication year:
- 2002
- Pagination:
- 221p.,bibliogs.
- Place of publication:
- Binghamton, NY
Five major ethnic groups are discussed: Chinese, Japanese, Indian, Korean, and Vietnamese Americans. Migratory grief and depression, social integration and health, ethnic-specific long-term care facilities, conceptions of dementia among caregivers, and elder mistreatment are also discussed.
No longer independent: the dynamics of care arrangements for frail elderly patients
- Author:
- CHOI Namkee G.
- Journal article citation:
- Journal of Gerontological Social Work, 32(3), 1999, pp.27-47.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study examines data from a 1991 American survey to examine the changes in care arrangements for elderly patients. Following the onset of their dependency, over 60 percent of elderly patients experienced at least one form of institutionalisation. A majority of those who remained in the community also experienced changes in living/care arrangements. The findings confirm that health-related need factors and race are significant determinants of institutionalisation immediately following the onset of dependency. But the availability of caregivers and other enabling factors are also significant determinants of care settings used following hospitalisation.