Social capital among older residents of a coastal resort: A survey of social resources and vulnerabilities

Objective: To document the characteristics and social networks of older residents of a coastal resort, as part of a qualitative study of their social capital. Methods: A 15‐item questionnaire was mailed to a sample of 200 Seniors’ Card holders, stratified by age and gender, resident in three postcodes in coastal New South Wales. While the purpose of the survey was to recruit volunteers for interviews, analysis of the 103 responses provided useful data about broad characteristics of the sample group. This paper presents results of this analysis. Results: The most common form of household was the couple without children and most respondents were optimistic about the availability of help from family and friends. Gender and age differences were identified in rates of living alone, having relatives nearby, going out, belonging to clubs and associations, volunteering and use of transport. Conclusion: Variations in social patterns both reflect and foreshadow the vulnerability of individuals to changes in life circumstances.     

‘I'm older and more interested in my community’: Older people's contributions to social capital

Aim: To explore and compare older people's contributions to social capital in a large rural community. Methods: Data were collected from a large representative sample (n= 1431), through a social capital questionnaire. The survey was cross‐sectional and measured frequency of participation across different age cohorts in informal social activities, group activities and community and civic activities. Results: Age and life stage pattern proved to be a factor in determining the types of activities people were involved in. While younger people were more involved in social participation that involved public places or group and sporting events, older people, particularly those in the retirement age group of 60–69 were more involved in community and civic activities. Conclusion: Older people living in non‐metropolitan areas are not only recipients of social capital. Their considerable involvement in volunteer groups, service clubs, church groups and local government demonstrates significant involvement in civic and community life.     

Knowledge and interest in ageing: a study of final‐year social work students

Objective: To evaluate social work students’ knowledge of older people's issues and their interest in working with older people in the future. Method: Fifty‐five final‐year students completed a questionnaire, including a knowledge/myths instrument and an interest scale. Independent variables included students’ prior contact with older people and exposure to a course on ageing. Results: Students achieved an average 70.4% success rate on the knowledge/myths instrument; no student got all answers correct. Interest levels were moderate with an average score of 5.13 on a 10‐point scale. Prior participation in ageing courses was positively correlated with knowledge of older people's issues and interest in working with older people. Conclusions: Correlations between course attendance and students’ knowledge and interest are in line with international findings. Such courses should challenge common myths associated with ageing and should promote social work with older people as skilled practice within complex health, welfare and family systems.     

Readiness for utilizing digital intervention: Patterns of internet use among older adults with diabetes

ObjectivesThe Internet is an important source of health and self-care information for older adults with diabetes. This study examined whether older adults with diabetes can be classified into different profiles based on Internet use.MethodsA latent class analysis based on 10 Internet activities was conducted using a nationally representative sample of individuals aged 65 and older (N = 1919). A multinomial logistic regression was performed to explore the potential differences related to socio-demographic characteristics and health-related factors among the classes.ResultsThree distinct classes were identified based on Internet use: non-users (n = 1299, 67.6%), communicating users (n = 327, 17.4%), and smart users (n = 293, 15.3%). Smart users were more likely to be highly educated, wealthy, and socially active, and to have good physical and cognitive functioning abilities in comparison, to the other classes. The communicating users were defined by a low incidence of depression.ConclusionOlder adults with diabetes are a diverse group in terms of their Internet activities. Distinguishing among the various types of older adults with diabetes can help healthcare providers tailor their approach to encourage such adults to engage in digital self-care.     

Improving older people's life satisfaction via social networking site use: Evidence from China

Objective

This study aimed to examine the pathways by which social networking sites (SNSs) can improve older people's life satisfaction.

Methods

We conducted an online survey in China that lasted eight weeks. Respondents were required to report their demographic characteristics and feelings regarding SNS use. Data were analysed using SPSS 20 and Amos 21.

Results

We collected 596 valid samples. The empirical results show that SNS use improves older people's life satisfaction by reducing their loneliness and improving their self‐efficacy. Social support alleviates the negative effect of loneliness and enhances the positive effect of self‐efficacy on life satisfaction. Sex differences and education differences were significant. Men and less educated people had higher levels of life satisfaction.

Conclusion

Policymakers should offer support to SNSs targeting older people and encourage them to provide more useful services. SNS operators should encourage social support among older users and pay attention to sex differences and education differences.     

Community-based structural social capital and depressive symptoms of older urban Chinese adults: The mediating role of cognitive social capital

ObjectivesThe present study aimed to investigate the mediating role of cognitive social capital in the association between community-based structural social capital and depressive symptoms among older adults living in urban China.MethodsData were derived from a community survey conducted in Suzhou City, China, in late 2015 with 456 respondents aged 60 or older. Structural equation modeling was used to test the proposed hypothesis.ResultsThe latent variables of cognitive and structural social capital were established. Cognitive social capital was found to have a mediation effect on the association between structural social capital and depressive symptoms, even after controlling for the respondents’ sociodemographic characteristics, health status, and family variables.ConclusionsThe findings support the utility of social capital theory in urban Chinese contexts. A more comprehensive assessment tool to measure structural social capital should be built nationwide. Fostering cognitive social capital should play an important role in interventions aiming to enhance structural social capital among older adults. Policy and intervention implications are discussed.     

A flicker paradigm for inducing change blindness reveals alcohol and cannabis information processing biases in social users

Aim To apply a new paradigm using transient changes to visual scenes to explore information processing biases relating to ‘social’ levels of alcohol and cannabis use. Participants Male and female student volunteers (n = 200) not self‐reporting substance‐related problems. Setting Quiet testing areas throughout the university campus. Design A flicker paradigm, for inducing change blindness with lighter and heavier social users of alcohol (experiment 1, n= 100) and social users and non‐users of cannabis (experiment 2, n= 100), explored the associations between habitual level of use and the latency to detection of a single substance‐related or neutral change made to a scene of grouped substance‐related and neutral objects. Measurements Alcohol use was measured as the number of units of the heaviest drinking day from the previous week; cannabis use as the number of months of use in previous 12. Change–detection latency comparisons were used to evaluate processing biases. Findings In both experiments, (i) heavier social users detected substance‐related changes quicker than lighter and non‐users; (ii) lighter and non‐users detected substance‐neutral changes quicker than heavier users; (iii) heavier social users detected substance‐related quicker than substance‐neutral changes; and (iv) lighter and non‐users detected substance‐neutral changes quicker than substance‐related changes. Conclusions Alcohol and cannabis processing biases are found at levels of social use, have the potential to influence future consumption and for this reason merit further research.     

Assessment of the abbreviated Duke Social Support Index in a cohort of older Australian women

Objectives: To assess the acceptability, reliability and validity of the 11‐item Duke Social Support Index (DSSI) in community‐dwelling older Australian women, and to describe its relationship with the women's sociodemographic and health characteristics. Methods: Women aged 70–75 years were randomly selected from the national Medicare database, with over‐sampling of rural and remote areas. The mailed survey included items about social support, Medical Outcomes Study Short Form Health Survey (SF‐36), health service use, recent life events and sociodemographics. Results: All DSSI items were completed by 94% of the 12 939 participants. Internal reliability was reasonable for 10 of the 11 DSSI items and its factors, social interaction (four items) and satisfaction with social support (six items; Cronbach's alpha of 0.8, 0.6, 0.8). The factor structure was consistent for subgroups of women: urban/non‐urban; English speaking/non‐English speaking background; married/widowed. Summed scores were highly correlated with factor scores and showed good construct validity. Higher social support was associated with better physical and mental health, being Australian born, more educated and better able to manage on income. Conclusion: Ten of the 11 DSSI items provided an acceptable, brief and valid measure of social support for use in mailed surveys to community‐dwelling older women.     

“Moderate” and Hard Drug Users among College Students: A Study of their Drug Use Patterns and Characteristics *

Abstract This study compared the drug use patterns and characteristics of a group of noninstitutionalized “moderate” drug users with those of a hard drug user group-One hundred college students were administered a drug data sheet which served to categorize Ss into “moderate” and hard drug-taking groups as well as to determine their individual drug use patterns. Results indicated the two groups were equated on most social and demographic variables. The “moderate” users differed significantly from the hard users along many drug-use dimensions. Hard users appear to be considerably more “friend-dependent” for their drug information and in their motivation to take drugs than are the “moderate” users. Alcoholic beverage consumption among hard users’parents was significantly greater than “moderates” parents. The implication of these findings, as well as others, are discussed along with some suggestions for further research.     

Characteristics of older dietary supplement users: review of the literature

Published literature reports rates of dietary supplement usage by individuals aged 60 years or more to be 16?60%. Prevalence figures are dependent on the population studied and the method of data collection. In general, older supplement users are female, Caucasian and well educated, with healthier lifestyle practices than non‐supplement users, and they are less likely to be overweight or to smoke. Neither income nor self‐rated health status are reliable predictors of supplement use in this group. In many cases older supplement users report higher intakes of several micronutrients from food than older non‐supplement users. Current patterns of supplement use by the older person reveal that although they consume a range of products, they do not supplement with nutrients that are of particular benefit to them. The supplements most commonly consumed by individuals aged 60 years and over are multivitamins and minerals, vitamin C and vitamin E preparations. There is insufficient data to quantify the dosage, frequency and duration of supplement use by the older population. Obtaining this information and data about herbal medicine use is an important step towards minimising the risk of drug–nutrient–herbal interactions. Identifying the health professionals who monitor the appropriateness and safety of supplement use in older individuals, particularly given the already high use of medication in this population, also needs to be a focus of future utilisation investigations. This systematic review of the literature published between 1982 and 2003 aims to measure the patterns of dietary supplement use by community‐living individuals aged 60 years and over and to profile the characteristics of older supplement users.     

Long‐Term Effectiveness of Screening for Hearing Loss: The Screening for Auditory Impairment—Which Hearing Assessment Test (SAI‐WHAT) Randomized Trial

OBJECTIVES: To evaluate the effect of hearing screening on long‐term hearing outcomes in a general population of older veterans. DESIGN: Hearing loss in the elderly is underdetected and undertreated. Routine hearing screening has been proposed, but it is not clear whether screening identifies patients who are sufficiently motivated to adhere to treatment. A four‐arm randomized clinical trial was conducted to compare three screening strategies with no screening in 2,305 older veterans seeking general medical care. SETTING: Veterans Affairs Puget Sound Health Care System. INTERVENTIONS: The screening strategies were a tone‐emitting otoscope, a widely used questionnaire about hearing handicap, and a combination of both tools. MEASUREMENTS: Hearing aid use 1 year after screening. RESULTS: Of participants who underwent screening with the tone‐emitting otoscope, questionnaire, and combined testing, 18.6%, 59.2%, and 63.6%, respectively, screened positive for hearing loss (P<.01 for test of equality across three arms). Patients proceeded to formal audiology evaluation 14.7%, 23.0%, and 26.6% of the time in the same screening arms, compared with 10.8% in the control arm (P<.01 for test of equality across four arms). Hearing aid use 1 year after screening was 6.3%, 4.1%, and 7.4% in the same arms, compared with 3.3% in the control arm (P<.01). Hearing aid users experienced significant improvements in hearing‐related function and communication ability. CONCLUSION: In older veterans, screening for hearing loss led to significantly more hearing aid use. Screening with the tone‐emitting otoscope was more efficient. The results are most applicable to older populations with few cost barriers to hearing aids.     

General and health-related Internet use among an urban,community-based sample of HIV-positive women: implications for intervention development

Internet-based HIV interventions are increasingly common, although little focus has been on HIV-positive women. To understand the feasibility of using the Internet to deliver behavioral interventions to HIV-positive women, we sought to describe patterns of Internet use for general and health-related purposes and to explore differences between Internet-using and non-using women. From February 2014 to April 2014, 103 women were recruited at six community-based organizations in the Bronx, NY that provide services to HIV-positive persons. Women completed a 30-minute interview and answered a brief survey of socio-demographic factors, risk behavior and clinical characteristics. We performed χ² and Kruskal-Wallis tests to compare Internet users and non-users. Sixty-one percent of participants were current Internet users, most of whom used a personal electronic device (e.g., cellphone/smartphone) to access the Internet. While higher proportions of Internet users were passively engaged (e.g., signed up to receive email updates [42.9%] or watched an online video [58.7%] for health-related purposes), smaller proportions (12.7–15.9%) were involved in more interactive activities such as posting comments, questions, or information about health-related issues in an online discussion or a blog. A majority of Internet non-users (60.0%) expressed interest in going online. Lack of computer or Internet access (37.5%) and Internet navigation skills (37.5%) were the primary reasons for non-use. Compared with non-users, Internet users were more likely to be younger, to have higher socioeconomic status, and to report low health-related social support. Despite having a lower proportion of Internet users in our study than the general population, Internet-using women in our study had relatively high levels of online engagement and went online for both general and health-related purposes. However, Internet-based interventions targeting HIV-positive women will likely need to include providing computer and/or Internet access as well as training participants in how to navigate the Internet.     

Characteristics of social support in a community‐living sample of older people: The Sydney Older Persons Study

Objectives : Lower levels of social support have been associated with higher mortality, poor health and lower levels of well‐being. The aim of this study is to describe the characteristics of social support in a sample of community‐living people over the age of 75 years and secondly to identify sociodemographic variables associated with social support. Method : A sample of 647 community‐dwelling elderly (75 or older) were interviewed using a structured instrument assessing social support. Social support was defined as: instrumental support; emotional support including the presence of a confidant; perceived support (perceived availability and perceived adequacy of support) and finally, social involvement or participation. Chi‐squared tests were used to compare levels of social support between males and females. Univariate and multivariate linear regression analyses were conducted in order to examine the relationship between social support and sociodemographic variables.     

Moderating Effects of Community Social Capital on Depression in Later Years of Life: A Latent Interaction Model

Objective: This study tested the stress-buffering model and examined the buffering role of community social capital on late-life depression.

Methods: This study used the data from the second wave of National Social Life, Health, and Aging Project (NSHAP, 2010–2012). In the present study, a total of 2,362 older adults aged 65 and older (Mage = 74.5, SD = 6.69) were included. Latent moderated structural equations model was tested by comparing the main effect model and interaction model. Depression, stress, and community social capital were constructed as latent variables for the analyses.

Results: The main effect model was acceptable: χ² (df = 334) = 1596.4, p = .000; RMSEA = .04 (.038 - .042); CFI = .91; and SRMR = .05. And interaction model was significant (D = 35.0, p < .001). The latent constructs of stress (β = . 50, p < .001) and community social capital (β = ?.14, p < .001) not only had a direct effect on depression, but their interaction was also significant (β = ?.21, p < .01).). The group with a high level of social capital presented a relatively stable slope in the prediction of stress on depression, suggesting their resilience, while the group with a low level of community social capital demonstrated a steep slope, indicating heighten vulnerability to depression when faced with stress.

Conclusions: The findings support the hypothesis of stress buffering model and identify the protective effects of community social capital on depression of older adults.

Clinical Implications: Older adults with lower community social capital are particularly vulnerable to depression. The results highlight that practitioners and policymakers should pay more attention to finding ways to enhance community resources to improve older adults’ mental health.     

Empowerment of Senior Citizens via the Learning of Information and Communication Technology

Most East Asian countries have policies to promote digital inclusion, especially among the children of low-income families and persons with disabilities, for the purposes of social development. However, such efforts and their impact among older people have been rather limited. In Hong Kong, only 7 % of those aged 65 or above were Internet users in 2008, compared with 66.7 % of the general public. Providing computer and Internet training programmes to older people is thus crucial in promoting digital inclusion. This paper discusses the experience and results of training older people to use both a computer and the Internet. Based on findings from an earlier qualitative study, we hypothesise that acquiring knowledge of computers and Internet use will have an empowering effect for older people in terms of increasing self-efficacy and enhancing communication with friends and family members. This paper presents two studies of such empowerment among older people in two non-governmental organisations (NGOs). While older people with little computer knowledge showed some effects of empowerment, at the same time, they also became more aware of the marginalisation and exclusion effects of their limited knowledge of computer and Internet usage. However, among users with some prior experience of using a computer, further training failed to show additional positive empowerment results. The results of the two studies call for a re-examination of the training process and experience of older people as well as integration of such training with other strategies to achieve better results in promoting their social inclusion in the information society.     

Independent living units: Managing and renewing an ageing stock

Objectives: To report on a key challenge (and its implications) that Australian not‐for‐profit organisations face as they manage and renew an ageing stock of independent living units (ILUs) for older people. Methods: A national survey of ILU organisations complemented by 28 interviews with ILU managers, peak aged care organisations and government officers, and five workshops with ILU managers. Results: ILUs are a policy response to the housing needs of older people with low income and limited assets. However, ILU organisations face significant challenges as the overall condition of ILUs deteriorates, as they seek to meet higher expectations and as they move into a phase of renewal. Conclusions: The future of ILU organisations is at a watershed, with many reconsidering their role as providers of ILUs. Any extensive reduction in ILUs will have implications for older people, for public housing providers and for delivery of community care to older renters.     

Brief Report: Personal emergency alarms: What impact do they have on older people's lives?

Objectives: To determine if, how often and in what types of situations older people use personal alarms and to explore the impact of personal alarm technology on older people's lives. Methods: This study was retrospective and involved a mail‐out survey to 2610 users of the Silver Chain CareLink Personal Alarm Service. Results: Clients wear their alarm consistently around their home and in the garden; however, use is low in the shower/bath and in bed at night. Clients reported positive impacts in terms of: gaining faster assistance in an emergency, extending the time they are able to remain living at home, increasing their sense of security, reducing anxiety about falling and increasing confidence in performing everyday activities. Conclusions: Personal alarms have many positive impacts on the lives of older people.     

An Internet‐Based Communication Network for Information Transfer During Patient Transitions from Skilled Nursing Facility to the Emergency Department

OBJECTIVES: To determine whether the implementation of an Internet‐based communication system improves the amount of essential information conveyed between a skilled nursing facility (SNF) and the emergency department (ED) during patient care transitions. DESIGN: Interventional; before and after. SETTING: ED of an urban teaching hospital with approximately 55,000 visits per year and a 55‐bed subacute free‐standing rehabilitation facility (the SNF). PARTICIPANTS: All patients transferred from the SNF to the ED over 16 months. INTERVENTION: An Internet‐based communication network with SNF–ED transfer form for communication during patient care transitions. MEASUREMENTS: Nine elements of patient information assessed before and after intervention through chart review. Secondary outcomes: changes in efficiency of information transfer and staff satisfaction. RESULTS: Two hundred thirty‐four of 237 preintervention and all 276 postintervention care transitions were reviewed. The Internet communication network was used in 78 (26%) of all care transitions, peaking at 40% by the end of the study. There was more critical patient information (1.85 vs 4.29 of 9 elements; P<.001) contained within fewer pages of transfer documents (24.47 vs 5.15; P<.001) after the intervention. Staff satisfaction with communication was higher among ED physicians after the intervention. CONCLUSION: The use of an Internet‐based system increased the amount of information communicated during SNF–ED care transitions and significantly reduced the number of pages in which this information was contained.     

The acute–aged care interface: Exploring the dynamics of ‘bed blocking’

Objective: To understand the dynamics underlying ‘bed‐blocking’ in Australian public hospitals that is frequently blamed on older patients. Methods: Analysis of primary and secondary data of utilisation patterns of hospital and aged care services by older Australians. Results: A model of the dynamics at the acute–aged care interface was developed, in which the pathway into permanent high‐care Residential Aged Care (RAC) is conceptualised as competing queues for available places by applicants from the hospital, the community and from within RAC facilities. The hospital effectively becomes a safety net to accommodate people with high‐care needs who cannot be admitted into RAC in a timely manner. Conclusion: The model provides a useful tool to explore some of the issues that give rise to access‐block within the public hospital system. Access‐block cannot be understood by viewing the hospital system in isolation from other sectors that support the health and well‐being of older Australians.