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International policy perspectives on independence in old age
- Author:
- PLATH Debbie
- Journal article citation:
- Journal of Aging and Social Policy, 21(2), April 2009, pp.209-223.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Although the promotion of independence is a common feature of policies on older people across the world, independence has a variety of meanings that are shaped by different social, political and economic contexts and by different values and attitudes towards older people. This study compares policies in Australia, Denmark, India and the UK. In Australia and the UK, liberal democratic values translate into support for individual independence in old age. In Denmark, a strong emphasis on social responsibility and the right to public services means that choice, rather than independence, for older people is the prime focus. In India, independence is of less significance in the context of economic constraints and strong social values supporting family responsibility for the care of older people. This analysis raises important questions about the promotion of independence as a goal in the aging policies of international bodies such as the UN and WHO.
Cultural and intergenerational narratives: understanding responses to elderly family members in declining health
- Authors:
- SPIRA Marcia, WALL Jack
- Journal article citation:
- Journal of Gerontological Social Work, 52(2), February 2009, pp.105-123.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
There has been growing recognition that to assist clients with multi-cultural backgrounds an understanding of diverse cultural practices is required. This is especially true in interventions with families of older adults in declining health. This article describes the use of cultural and generational narrative as an intervention to understand family behaviour and to create coherence between family members as they share stories of family life. Narratives, the stories people tell about their lives, depict the different ways that the elderly and their children experience the world. The stories are influenced by immigration, assimilation, development, interpersonal relationships, and life events. The differences between the cultural narratives of the elderly and the following generation are particularly apparent during times of chronic stress. The information gleaned from these stories can also be useful to help develop an effective approach to health care for the older adults and their families.
Factors influencing the physical activity levels of older people from culturally-diverse communities: an Australian experience
- Authors:
- BIRD Stephen, et al
- Journal article citation:
- Ageing and Society, 29(8), November 2009, pp.1275-1294.
- Publisher:
- Cambridge University Press
In order to inform future health and physical activity strategies, the authors aimed to investigate the barriers and facilitators to physical activity for older people from culturally-diverse communities in lower socio-economic status areas of the western suburbs of Melbourne. By questioning 333 older people from seven different communities, predictors of physical activity were also identified. The most common forms of physical activity reported across the Anglo-Celtic, Croatian, Greek, Macedonian, Italian, Maltese and Vietnamese cultural groups were walking, gardening, and shopping. Recreational or more formal exercise was undertaken by only 20%. Personal barriers to physical activity, such as poor health, lack of energy, being too tired, and low motivation were highly prevalent across all groups. Also across all the groups, perceptions of health and safety were more important than the external environment. More specific factors could be culturally driven. For example, ‘being self conscious of my looks’ was a concern among the Vietnamese, while Croatians and Macedonians were more likely to be affected by the weather. The study indicates that while there may be some cultural differences in the levels of and barriers to physical activity, they are only one of several other factors (for example, gender, age, neighbourhood) that need to be taken into account in programmes that seek to increase the physical activity of older people in the future.
Older Latina women and HIV/AIDS: an examination of sexuality and culture as they relate to risk and protective factors
- Authors:
- BEAULAURIER Richard L., CRAIG Shelley L., de la ROSA Mario
- Journal article citation:
- Journal of Gerontological Social Work, 52(1), January 2009, pp.48-63.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Older Latina women are among the fastest growing groups of new AIDS cases, but also among the least studied: 20% of all women ever diagnosed in the US are Latina, and 6% of Latinas infected by 2002 were 55 and over. The number of diagnosed infections is increasing among older Latinas, although declining among younger women, and there is a potentially large number of misdiagnosed or undiagnosed cases. Risk and protective factors related to gender roles, traditional family values, religion, socioeconomic status, health and health care are discussed, with particular reference to the triple jeopardy of being female, older and of minority status. The paper concludes with recommendations for culturally competent practice with older Latinas and the development of a research agenda to explore their risk-taking and health-seeking behaviours.
Attitudes toward mental health services: age-group differences in Korean American adults
- Authors:
- JANG Yuri, CHIRIBOGA David A., OKAZAKI Sumie
- Journal article citation:
- Aging and Mental Health, 13(1), January 2009, pp.127-134.
- Publisher:
- Taylor and Francis
The present study examined the attitudes toward mental health services held by younger (aged 20-45, n = 209) and older (aged 60 and older, n = 462) groups of Korean Americans. Predisposing (age, gender, marital status and education), need (anxiety and depressive symptoms) and enabling (acculturation, health insurance coverage and personal experience and beliefs) variables were considered. In the mean-level assessment, younger and older adults were found to hold a similar level of positive attitudes toward mental health services. In the multivariate analysis, culture-influenced beliefs were shown to have a substantial contribution to the model of attitudes toward mental health services in both age groups. The belief that depression is a medical condition was found to be a common predictor of positive attitudes across the groups. In the older adult sample, more negative attitudes were observed among those who believed that depression is a sign of personal weakness and that having a mentally ill family member brings shame to the whole family. The findings show that older adults are not only more subject to cultural misconceptions and stigma related to mental disorders, but also their attitudes toward service use are negatively influenced by the cultural stigma. The findings provide important implications for interventions targeted to improve access to mental health care among minority populations. Based on the similarities and differences found between young and old, both general and age-specific strategies need to be developed in order to increase effectiveness of these programs.
Wrapping and unwrapping emotions: clinical practice with East Asian immigrant elders
- Authors:
- SHIBUSAWA Tazuko, CHUNG Irene W.
- Journal article citation:
- Clinical Social Work Journal, 37(4), December 2009, pp.312-319.
- Publisher:
- Springer
- Place of publication:
- New York
Using the cultural norm of the way gifts are wrapped, unwrapped, and exchanged as a metaphor for interpersonal connections, this paper presents the way therapists can establish therapeutic relationships with East Asian clients who do not express emotions openly. First, the ways in which emotions are conceptualized, experienced, and expressed in East Asian cultures are discussed. Then vignettes of work with older Chinese and Japanese immigrant women are presented to illustrate the importance of therapist authenticity and co-construction of the therapeutic relationship. Using the framework of relational/cultural theory, which posits that healing takes place in the context of mutually empathic growth-fostering relationships, the importance of establishing mutuality between therapist and client as a form of cultural empathy are highlighted..
Housing, care and inheritance
- Author:
- IZUHARA Misa
- Publisher:
- Routledge
- Publication year:
- 2009
- Pagination:
- 156p.
- Place of publication:
- London
Housing issues surrounding the ageing society are of increasing concern to many mature economies. Drawn from a two-part study funded by the UK Economic & Social Research Council, the author explores the myths and the changing patterns of long-term care and housing assets as they apply to the relationships between older parents and their adult children in Britain and Japan. The book addresses such questions as: If an adult child provides care for their elderly parent, should they be rewarded? If so, should they inherit their parent’s house or a larger share of the assets? Because the ‘generational contract’ is often influenced by cultural norms, family traditions, social policy and housing markets it is negotiated differently in different societies and at different times. It is suggested that these “generational contracts” are breaking down as a result of socio-economic and demographic changes. Subjects discussed include: intergenerational reciprocity and cultural practice; housing assets and intergenerational transfer in a global context; long term care and the shifting of the state-family boundaries; accumulation of housing wealth and family relations; plans for disposal of assets; and rethinking the ‘generational contact’ between housing, care and inheritance.
Relationship between productive activities, family relations, and aging well for elders in China
- Authors:
- MJELDE-MOSSEY Lee Ann, et al
- Journal article citation:
- Journal of Ethnic and Cultural Diversity in Social Work, 18(4), October 2009, pp.276-292.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
By understanding how culture interacts with aging well social workers can enhance their cultural competence in practice, policy and research. This study explored determinants of aging well in elders in China. In traditional Chinese culture, elders have assumed a socially integrated and productive social role within the family; paralleling the active engagement domain of the Rowe and Kahn model of successful aging. However, this model focuses on health and physical functioning with less emphasis on psychosocial aspects such as culture. The authors tests the strength of the relationship between two variables representative of Chinese aging traditions, productive activity and family relations, and the two indicators of aging well, self-rated health and depression. In home interviews were conducted with 1,502 randomly selected Chinese elders aged 60 or over from three different regions. Two hierarchical regression models were tested. Step one used age, gender, marital status, financial adequacy, living alone, and reading ability. Step two added the active engagement variables of productive activity and family relations. Each model was significant at both steps with an inverse association for depression and a positive association for self-rated health. The authors suggest that despite rapid modernisation, family mobility and loss of traditional values, Chinese elders have not been completely marginalised and younger generations still have an imperative to provide support. However they suggest that elders will be challenged to create new pathways to remaining socially integrated and contributory.
Healthcare-seeking behaviours of older Iranian immigrants: health perceptions and definitions
- Author:
- MARTIN Shadi Sahami
- Journal article citation:
- Journal of Evidence-Based Social Work, 6(1), January 2009, pp.58-78.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The purpose of this qualitative study was to explore how cultural differences influence the healthcare-seeking behaviours of older Iranian immigrants in the United States. Older immigrants were defined as Iranians who were aged 50 years or more when they left their country. Cultural differences were examined in a variety of areas including definitions and perceptions of health, illness and care. Seven men and eight women, aged 53 to 87 years, completed in-depth, semi-structured interviews. The findings showed that participants’ definitions of health, illness and care differ significantly from mainstream Western definitions. The results demonstrated that these differences influence the participants’ healthcare-seeking behaviours. For example, Iranian immigrants define health holistically (including the mind, body, emotions and spirit) and, hence, they expect their health providers to care for them as a whole person and to not just focus on illness/disease elimination. The older Iranian immigrants’ frustration with Western medicines’ lack of attention to their “ruh” combined with their lack of trust in modern medicine and their pride keep many of them from seeking care when needed and from complying with their treatment. The author makes recommendations for change which include cultural training for medical staff and the use of cultural brokers.
The personalisation of dementia services and existential realities: understanding Sikh carers caring for an older person with dementia in Wolverhampton
- Authors:
- JUTLLA Karan, MORELAND Neil
- Journal article citation:
- Ethnicity and Inequalities in Health and Social Care, 2(4), December 2009, pp.10-21.
- Publisher:
- Emerald
The authors argue that, while it is important to consider demographic aspects, it is also important to consider the existential realities (the ontology) of the lives and cultures of those in minority ethnic groups when assessing difficulties found in these communities with accessing dementia services. In this context, they discuss the diversity and complexity of migration patterns among the Sikh community living in Wolverhampton and conceptualise some of the ways in which different migration experiences and the realities of daily life influence the perceptions, experiences and patterns of care among migrant Sikh carers in Wolverhampton caring for an older person with dementia. The paper explores the thesis that the Sikh community is not a homogeneous group; and that the diversity and differences within the Sikh community can have important implications for care. Stories of 2 carers are given as illustrative case studies. The authors comment that, taking a biographical narrative approach to fieldwork, the relevant factors to be considered include: the carer's country of origin; their migration route and reasons for migration; their age at migration and the cultural experiences of the carers and their communities both in the UK and India.