Intergenerational Family Relations and Life Satisfaction Among Three Elderly Population Groups in Transition in the Israeli Multi-cultural Society

The study aims to illuminate the links between personal and familial resources and wellbeing of elders 65+ in three population groups in Israel: kibbutz members, new immigrants from the former Soviet Union and Arabs—all of whom are undergoing different types of personal, social and economic transitions. About 70 respondents in each group were interviewed regarding life satisfaction, familial relations based on the paradigm of intergenerational family solidarity and personal resources (socio-demographic and physical functioning). The main conclusions of this study are: the lives of the elderly immigrants are much more disruptive by the transitional migration processes they are undergoing and this affects their well-being which was much lower than the other two groups. Additionally they received more help from the family. Family solidarity, mainly opportunity structures and emotional bonds were especially strong among the Arabs, with the lowest level of conflict. The Arab elderly were also different from the other two groups in the lower level of help they provided to their adult children, probably due to their more limited level of personal resources and the differing social expectations. The majority of respondents acknowledged some degree of filial obligations, although much lower among kibbutz members. Personal resources (physical functioning and financial adequacy) had the strongest effect on life satisfaction in all three groups. The dimensions of family solidarity played a less dominant role. The discussion highlights the distinctive family culture of the three groups, the transition they face, and their differential resources with some policy recommendations.

A possible innovative association between the concept of inter-generational ambivalence and the emotions of guilt and shame in care-giving

The present article suggests a tentative new theoretical association between the concept of intergenerational ambivalence and the emotions of guilt and shame in care-giving. The article bases the above suggestion on the paradigm of intergenerational ambivalence as well as on existential and psychological emotion theories dealing with guilt and shame. In certain typical care-giving situations (e.g., leading to institutionalization of the elderly) feelings of guilt can mirror personal-subjective ambivalence (micro level ambivalence) while feelings of shame can mirror institutional-structural ambivalence (macro level ambivalence). The article exemplifies this idea, using an empirical study, which was conducted in Israel (1995), about guilt emotions of care-givers in the Kibbutz versus the city, concerning the institutionalization of an elderly parent. In order to support this innovative concept in the gerontological literature, more updated empirical proof is yet needed. Conclusions and implications of the association between guilt, shame and intergenerational ambivalence are discussed, from theoretical and practical perspectives.

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The influence of living arrangements, marital patterns and family configuration on employment rates among the 1945–1954 birth cohort: evidence from ten European countries

As they approach retirement, Europeans in mid-life display a range of living arrangements and marital patterns. These configurations influence labour force participation for men and women in different ways and these differences are accentuated between countries. Using data from the first Wave (2004) of the Survey on Health, Ageing and Retirement in Europe (SHARE), the paper examines the relationship between living arrangements, marital patterns, family configurations and participation in the labour force for the birth cohort of 1945–1954. The data show that the probability of being in paid employment was higher for respondents living in a couple in northern Europe than in southern Europe. In all countries, men in a couple had significantly higher employment rates than women in a couple, but employment rates of women in a couple differed significantly between countries. Multivariate analysis with country effects confirmed the negative influence of age, poor health, lower levels of education and household income on the probability of being in paid employment, but the effect of variables concerning living arrangements, marital patterns and family configurations varied according to country. A multilevel analysis showed that the between country variance of being in paid employment could not be explained by individual characteristics alone, that a large part of the country variance could be explained by the country specific effect of women in a couple, and that the level of ‘modern’ life styles in each country (rates of cohabitation outside marriage, divorce or separation and recomposed families) had a significant effect on employment rates, especially for women in a couple.

European patterns of intergenerational financial and time transfers

The ageing of the European population is expected to strongly influence both the structure of family relations and the pattern of private transfers between generations. Using data from the Survey of Health, Ageing and Retirement in Europe conducted from the perspective of adults aged 50 and above in ten European countries, we provide an analysis of financial and time transfers, either given or received. Our results show that cash gifts mainly flow to the younger generations, while time transfers are directed both upwards and downwards. When comparing the countries, we find some remarkable similarity in the pattern of transfers, although there are inter-country differences. These differences sometimes follow the expected north-south European gradient, but not always. The results suggest that the social and demographic transformations currently taking place in Europe often have contradictory and paradoxical effects upon the nature of intergenerational exchanges.

Personality and health in middle age as predictors for well-being and health in old age

In research literature, the question to what extent specific personality traits and health functioning in midlife can predict physical and psychological well-being in old age is still discussed controversially. The present study aims to shed light on this issue by using data from the Basel Longitudinal Study on Ageing. Structural equation modelling was performed in order to test the relation between personality dimensions, namely, self-preoccupation and emotional reactivity, as well as cardiovascular functioning (blood pressure) and medication intake (tranquilizer use) in middle age on psychological and physical well-being and health as assessed in old age 24 years later. Results show that high levels of self-preoccupation in middle age are negatively related to psychological and physical well-being in old age, but not to medical diagnoses. In addition, blood pressure and tranquilizer use in middle age predict physical well-being in old age; blood pressure is furthermore related to medical diagnoses. Our findings emphasize the importance for the adoption of a life-span approach and further interdisciplinary prospective studies in order to better predict pathways to well-being and health in old age.

Immigrants and Long-distance Elder Care: An Exploratory Study

In this paper we explored the rationales and the processes among five Ghanaian immigrants residing in two cities in the Mid-Atlantic region of the USA for providing care and support to their older adult relatives in Ghana. Although some of our participants indicated that elder care duties could sometimes be overwhelming, all expressed their willingness and desire to continue to provide care for their older adult relatives. Provision of elder care was viewed as a way to show family solidarity, and a means to demonstrate respect and appreciation to one’s older adult relatives and others who had provided support in the past. Our findings suggest older adults in Ghana can still rely on their family members who have migrated for care and support.

Serious health events and their impact on changes in subjective health and life satisfaction: the role of age and a positive view on ageing

Various studies have pointed to the great importance of subjective health as an indicator for mortality in older age, while less is known about factors that contribute to changes of subjective (self-rated) health over time. Based on a nationwide longitudinal survey (German Ageing Survey, N = 1,286; initial age 40–85), two major findings emerged: first, the incidence of a serious health event caused greater changes in subjective health and life satisfaction in middle compared to older age. This was as expected because serious health events are less common in middle age and are correspondingly experienced more often as an “off-time event”. Secondly, the study extended previous findings on the impact of a positive view of ageing on health by showing that this optimistic view positively affects subjective health and life satisfaction even in the face of a serious health event. Overall, the study indicates that a positive view on ageing is an important psychological resource in the case of a serious health event, both when it occurs on-time or off-time from a developmental perspective.

Die ELITE-Symphony-Studie

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Schulungen

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Diabetesbehandlung im Krankenhaus – Dringender Bedarf für strukturiertes Vorgehen

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Leitlinien der Deutschen Gesellschaft für Kardiologie—Herz- und Kreislaufforschung

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What Information Do Clinicians Use in Recommending Oral versus Nonoral Feeding in Oropharyngeal Dysphagic Patients?

There is little evidence regarding the type(s) of information clinicians use to make the recommendation for oral or nonoral feeding in patients with oropharyngeal dysphagia. This study represents a first step toward identifying data used by clinicians to make this recommendation and how clinical experience may affect the recommendation. Thirteen variables were considered critical in making the oral vs. nonoral decision by the 23 clinicians working in dysphagia. These variables were then used by the clinicians to independently recommend oral vs. nonoral feeding or partial oral with nonoral feeding for the 20 anonymous patients whose modified barium swallows were sent on a videotape to each clinician. Clinicians also received data on the 13 variables for each patient. Results of clinician agreement on the recommendation of full oral and nonoral only were quite high, as measured by Kappa statistics. In an analysis of which of the 13 criteria clinicians used in making their recommendations, amount of aspiration was the criterion with the highest frequency. Recommendations for use of postures and maneuvers and the effect of clinician experience on these choices were also analyzed.

Understanding Aging in a Middle Eastern Context: The SHARE-Israel Survey of Persons Aged 50 and Older

This article describes the development of SHARE-Israel, the survey of persons aged 50 and older in Israel, and preliminary results from an early data release. The introduction of an HRS-inspired computer-based survey into a Middle East country required linguistic and cultural adaptations of the survey mechanisms that had not been previously experienced in other countries. Preliminary findings showed that the majority group of veteran Jewish-Israelis aged 50 and over is in a favorable position in terms of health, employment status and household income compared to Arab-Israelis and to new immigrants to Israel from the Former Soviet Union. Arab-Israelis aged 50 and over are at greater risk due to greater disability and lower incomes. Recent immigrants from the former Soviet Union are at greatest risk. They report having the highest degree of depression, long term problems and activity limitation, the fewest children, low rates of home ownership and low incomes. Comparing the older Israeli population with their European counterparts revealed that Israelis are more depressed; more Israeli women are employed, and fewer Israeli men are retired; and household income in Israel is lower, but rises relatively when correcting for purchasing power parity. These trends point to several areas that will require attention in the formulation of public policy on behalf of the aging population in Israel.

Structural Displacements During the Swallow in Patients with Early Laryngeal Cancers and Other Early Primary Cancers of the Head and Neck

Spatial movement of pharyngeal structures involved in swallowing was assessed by videofluoroscopy in 24 patients with early (T1N0) carcinoma of the larynx prior to curative treatment using an identical radiotherapy regimen (55 Gy in 20 daily fractions), and in 24 patients who had early primary head and neck cancers in other locations that would not be expected to interfere with the pharyngeal swallowing process. There were no significant differences between the laryngeal cancer patients and the other patients. Measurements were generally consistent with previously reported results in volunteers with normal swallows. On univariate analysis, patients ≥70 vs. <70 years old had a significantly greater hyoid-laryngeal distance and pharyngeal area at rest. Patients with body mass index (BMI) ≥26 vs. <26 demonstrated a significantly greater maximal width of the pharyngo-oesophageal sphincter (PES) in the lateral view. Multiple regression revealed that greater hyoid-laryngeal distance at rest and at the point of maximal approximation were the significant predictors of male vs. female gender at the exclusion of all other variables, accounting for 59% of the variance. In no patient did contrast touch the vocal cords during the swallow. This study forms a baseline for future prospective evaluation of the effect of radiotherapy on the swallowing of patients with early laryngeal cancer.

Pseudodysphagia Due to Omohyoid Muscle Syndrome

Omohyoid muscle syndrome (OMS) is a rare clinical condition that has the pathognomonic feature of the appearance of a lateral neck mass when swallowing due to dysfunction of the omohyoid muscle (OH). We present two cases of typical OMS with electrophysiologic and dynamic imaging studies. The study results indicate that OMS is caused mainly by the loosening of the fascial attachment to the intermediate tendon of the OH. The characteristic clinical features and pathomechanism underlying OMS are also discussed.

Late-life Widowhood and Meaning in Life

The relationship between elders’ marital status and length of widowhood, as well as other personal and familial resources and the sense of meaning in life, as defined by logotherapy, was tested among 180 Israeli elderly community dwellers aged 64–95. Results show that an event such as late-life widowhood can create a loss of the sense of meaning in life. In addition, a significant difference was found between married and recently widowed elders in relation to meaning in life. Other variables that affected and explained meaning in life were subjective health, education, the quality of social support relationships, and activity level. The results support Frankl’s logotherapy approach, underscoring the importance of helping older people in general, and the widowed elders in particular, to discover and create new life meanings.

Gender Differences in Contributory Behaviors Among the Oldest-Old Chinese in Shanghai

This study examined gender differences in factors related to contributory behavior among the oldest-old aged 80+ in Shanghai, China. The study population included a randomly selected sample of 349 community dwelling respondents who lived in five districts. Male and female respondents contributed equally to others in informal networks, but in different ways. Objective health status and social ties are related to contributory behavior for both males and females. However, financial status and vision impairment had a different impact on males and females. Healthy aging and strong social networks are two key components for contributory behaviors.

Role of Cerebral Cortex Plasticity in the Recovery of Swallowing Function Following Dysphagic Stroke

Effective swallowing is an essential part of life and is performed thousands of times per day, often without conscious consideration. Difficulty in swallowing (dysphagia) commonly arises in stroke patients following ischemia of the cerebral cortex. However, whereas this tends to resolve spontaneously in the majority of patients, a small percentage will be left with a persistent dysphagia, which predisposes to airway compromise and aspiration pneumonia. This article reviews the recent research into ways of restoring swallowing function in these patients through promoting plasticity and reorganisation of the remaining, viable cerebral cortex.

Ageing in India

About 7.6% of India’s population is above 60 years old. The elderly in India face multiple social, political, economic and cultural challenges including suboptimal financial security, decline of traditional extended family systems due to rural-urban migration of young people, and increasing costs of health care. In India, as is the case in many developing countries, the health systems are inadequate to promote, support and protect health and social well-being of the elderly due in part to lack of human and financial resources. The elderly find themselves exposed to harsh realities of globalization; changes in cultural values and beliefs, high disease burden from chronic noncommunicable diseases, and weak family and social welfare system. To address the health and welfare needs of this vulnerable section of society, the Government of India in 1999 developed and adopted the National Policy for Older Persons. A National Council for Older Persons and an Inter-Ministerial Committee was set up to implement the policy directions. To date, Government of India with its partners, have introduced various schemes and initiatives to promote and protect the welfare of the elderly. These initiatives include financial assistance for the construction of and maintenance of old peoples’ homes and non-institutional services to the elderly, as well as the provision of nutritious food and appropriate medical services. The Government of India, through the National Rural Health Mission has embarked on efforts to strengthen provision of primary health services and to reorient health care professionals from curative to preventive services at various levels. However, challenges remain for the health system, social welfare and health financing as the elderly population continue to rise.