Predictors of satisfaction with children's help for younger and older elderly parents

In structured interviews, parents aged 60 to 90 described their children's work and family responsibilities, the practical and affective support they exchanged with each of their children, their satisfaction with assistance received from their children, and their values regarding family relationships. Self-reported general health, proximity values, and kin-orientation values predicted satisfaction with children's help for the total sample. For parents aged 74 and younger, proximity values, reciprocity in help exchanges, number of children helping relatives other than the participant, and number of children working outside of the home predicted satisfaction; for parents aged 75 and older, self-reported general health and kin-orientation values predicted satisfaction. It is concluded that values regarding families, interdependence, and autonomy provide a critical context for reactions to help by adult children.     

Motivation,personality and well-being in older volunteers

This study examined the effects of personality traits and motivation to volunteer on well-being as 107 older participants went through an intervention to increase volunteering. Three groups of volunteers, current, new, and former volunteers, participated. Participants were assessed four times on standardized measures of personality, health, motivation, and well-being: before and after a wait period, after volunteering, and at one year follow-up. There were no differences between pre, post and follow-up well-being. Regression analysis indicated that health, personality traits and motivation predicted well-being at pre-intervention. In contrast, after the intervention, regression analysis indicated that the interaction of higher neuroticism and greater motivation scores predicted lower well-being compared to other volunteers. One year follow-up results indicated that personality traits and health predicted well-being and that higher initial motivation predicted drop-outs while those continuing to volunteer increased their motivation scores.     

Oral care help to maintain nutritional status in frail older people

The purpose of this study was to evaluate the effect of continuous oral care on the nutritional status of older people who require care using a 1-year randomized, controlled study. Fifty-three residents of a nursing home in Japan participated in this study. Subjects were randomly divided into two groups, an oral care intervention group and control group. The subjects in the oral care intervention group received professional oral care from a dentist three times a week over the course of 1 year. Body weight, body mass index (BMI), serum albumin, and high-density lipoprotein cholesterol (HDL-C) were measured as objective indicators of nutritional status at baseline and after 1 year, and compared between the groups. In the oral care group, no significant decline was seen in all indicators from the start to the end of the intervention, but in the control group there was a statistically significant decline in all indicators at the end of the year. These results suggest that the intervention of oral care alone can serve to maintain the nutritional status of older people who require care. Implementation of continuous oral care is an important task from the viewpoint of maintaining nutritional status in older people.     

Relative contributions of help by employed and nonemployed sisters to their elderly parents

The relationship between daughters' employment status and involvement in the provision of services to old parents was examined using information collected from 50 pairs of sisters whose employment status differed. The Wilcoxon matched-pairs, signed-ranks test was used to assess whether employment status affected perceptions of parents' needs, relative contributions to parents, and relative contributions when parents' health status was poorer. Nonemployed sisters contributed relatively more tangible services than their employed sisters when parents' health status was poorer. Qualitative analysis of the interviews indicated that although nonemployed sisters usually took disproportionate responsibility for medical appointments and day-time emergencies and care, employed sisters were expected to contribute in other ways. That the significance of individual attributes of family members makes sense only within the family context is stressed.     

Perceptions of help given to healthy older mothers by adult daughters: ways of initiating help and types of help given

Older mother-adult daughter dyads (N = 43) addressed two issues pertaining to the ways in which help is initiated (offered, requested, and imposed help) and type of help given (instrumental help, advice, and emotional support) a) mothers' reasoning about these aspects of help, and b) daughters' understanding of mothers' feelings. Both groups noted that mothers were most comfortable with offered help; however, mothers indicated equal comfort with requested or imposed help, while daughters felt mothers were more comfortable with requested help than imposed help. Mothers and daughters both felt that mothers were less comfortable receiving additional instrumental help or advice than emotional support. Reasons given for mothers' feelings indicated that mothers saw both positive and negative elements in the help given by their adult daughters. Overall, daughters demonstrated a good understanding of mothers' feelings about the helping relationship.     

Interpersonal influences in adolescent drug use--the role of older siblings, parents, and peers

Drawing data from the first year of a longitudinal study of 508 families with focal adolescents aged 11 to 13 years and their older siblings (14 to 18 years), the investigators examined the influence of older siblings' drug-using attitudes and behaviors, in comparison with parental and peer drug-using attitudes and behaviors, on focal adolescents' nonuse and use of substances. Older siblings are frequently a source of drugs and use substances with their young siblings, though peers remain the primary source and the most frequent coursers. For most substances, frequency of use was predicted by older sibling and peer substance use, each after controlling for the other. Parental drug use was found to be minimal in comparison to older siblings and peers. Findings relative to the potentially important role of older siblings in influencing their younger siblings' drug-using behavior are discussed.     

居住安排与成年子女赡养老年父母的关系

目的探讨北京市老年人居住安排与成年子女赡养老年父母的关系。方法利用描述统计分析和Probit多元回归模型研究老年人居住安排与成年子女提供日常生活照料、经济支持的相关关系。结果老年人与成年子女同住,不但会提高需要时得到照料的概率,同时也有助于获得子女的经济支持。与成年子女同住、不同住的老年人获得日常生活照料的比例分别为79.85%和47.31%(P0.001),获得经济支持的比例分别为32.69%和26.66%(P0.001)。如果保持其他条件不变,与不同住相比,与成年子女同住的老年人得到日常生活照料和经济支持的概率将会分别提高32.2%(P0.01)和3.2%(P0.05)。结论老年人与成年子女同住是家庭养老在生活照料和经济支持方面的集中体现,也是目前对老年人最有利的一种居住安排方式。     

Forgone health care due to cost among older adults in European countries and in Israel

This study sought to identify the principal factors that predict forgone health care due to cost among European and Israeli older adults. The analysis applied the Andersen–Newman model of health service utilization to data from the first wave of the Survey of Health, Ageing and Retirement in Europe (n = 28,849). Relinquished health care was regressed on the predisposing characteristics, need factors and economic access attributes of the respondents, in general, and in each of 12 countries, in particular. The results showed that forgone health care due to cost occurs among a substantial minority of older adults. Moreover, relinquished care is associated with younger old age, greater health needs and perceived economic inadequacy. Although statistically significant in certain cases, country of residence does not constitute a robust predictor of health care relinquishment. Social policy should address the antecedents of forgone health care in order to more effectively meet the health needs of the older population.     

Infant rotavirus vaccination may provide indirect protection to older children and adults in the United States

Following the introduction of rotavirus vaccination in the United States, rotavirus and cause-unspecified gastroenteritis discharges significantly decreased in 2008 in the 0-4, 5-14, and 15-24-year age groups, with significant reductions observed in March, the historic peak rotavirus month, in all age groups. We estimate that 15% of the total 66 000 averted hospitalizations and 20% of the $204 million in averted direct medical costs attributable to the vaccination program were among unvaccinated 5-24 year-olds. This study demonstrates a previously unrecognized burden of severe rotavirus in the population >5 years and the primacy of very young children in the transmission of rotavirus.     

Relationship between social network and hypertension in older people in Spain

INTRODUCTION AND OBJECTIVES: To investigate the association between a patient's social network and hypertension risk in older adults in Spain and to determine whether the nature of the social network is related to a patient's awareness of hypertension, to disease treatment and control, or to adherence to hypertension drug therapy. PATIENTS AND METHOD: Cross-sectional study of 3483 subjects representative of the non-institutionalized Spanish population aged 60 years or more. Logistic regression analysis, adjusted for sex, age, educational level, lifestyle and frequency of medical consultation, was used to derive odds ratios (ORs) for associations between characteristics of the social network (e.g., marital status, cohabitation status, frequency of contact with family members, and frequency of contact with friends and neighbors) and aspects of hypertension. RESULTS: The hypertension risk in married individuals and those living with others was less than in those who were unmarried (OR=0.79; 95% confidence interval [CI] 0.67-0.94) or who lived alone (OR=0,75; 95% CI, 0.61-0.93). Men who saw their friends frequently were more likely to be aware of hypertension (OR=1.57; 95% CI, 1.19-2.07). Women who saw their friends or neighbors frequently were less likely to be aware (OR=0.70; 95% CI, 0.51-0.97). No clear relationship between social network characteristics and other hypertension-related variables was observed. CONCLUSIONS: In older adults, hypertension was associated with aspects of social integration, such as marital and cohabitation status. Among hypertensives, awareness of hypertension was partly related to the frequency of contact with family and friends or neighbors.     

Chronic disease,functional status,and self-ascribed causes of disabilities among noninstitutionalized older people in Spain

BACKGROUND: A major component of disability is related to chronic disease, but the study of self-reported causes of disability could add new aspects in understanding this process. The main objective of this work was to determine the associations between chronic diseases and disability and to describe the pattern of self-reported causes of the disabilities present in older persons. METHODS: We carried out a survey in a probabilistic sample of people aged 65 and older of the city of Madrid. The initial sample size was 1001. Subjects were interviewed in their homes. We asked about the presence of 14 chronic conditions. Self-reported difficulty and dependence in 9 noninstrumental activities of daily living (ADLs) were ascertained. Subjects were asked to report the main cause responsible for the disability. Multivariate logistic regression models were constructed to estimate the association of each chronic condition with the probability of having disability. RESULTS: Final sample size was 772 people (overall response rate 77.0%). Interviews answered by proxies were 7.5%. Only 4.5% declared no chronic condition. Osteoarthitis/rheumatism was the most prevalent condition (56.8%). In addition, 63.2% were independent, 21.3% were independent with difficulty (in at least one ADL), and 15.5% were dependent (in at least one ADL). Subjects attributed to osteoarthitis and to aging 41.8% and 17.1% of all disabilities, respectively. Chronic conditions strongly associated with disability were cerebrovascular disease (adjusted odds ratio [OR]: 3.51 [95% confidence interval: 1.44-8.60]), depression/anxiety disorders (OR: 2.72 [1.83-4.05]), and diabetes (OR: 2.18 [1.24-3.83]). CONCLUSIONS: Cerebrovascular diseases, depression/anxiety disorders, and diabetes were the conditions more clearly related to disability. On the other hand, a large proportion of subjects attribute their disabilities to osteoarthritis and old age.     

Determinants of home-based formal help in community-dwelling older people in Finland

Knowledge of the determinants of use of formal home-based services among older people is of particular importance for predicting the need for and cost of care in the future. The aim of this study was to estimate the frequency of formal and informal help among community-dwelling older people and to assess the determinants of home-based formal help, with a special emphasis on the frequency of help from spouse, from children and other relatives and friends. We used nationally representative cross-sectional data from 1,166 community-dwelling Finnish persons aged 70–99. Determinants of formal help were assessed with logistic regression models. Receiving formal help was most strongly related to need factors such as age and functional capacity. Adjusted for need factors, receiving help from spouse or living with someone else than the spouse decreased the odds of receiving formal help. In contrast, the more frequently the children helped, the larger were the odds of receiving formal home-based help. Help from other informal sources did not affect receipt of formal help. Our results thus suggest that intra-household help from spouse or from other co-residents may partly offset expected cost increases in the formal care sector brought about by an aging population. The results further suggest that help from children and help from formal sources is likely to be concomitant and that children may act as agents seeking formal help also in a welfare state based on the universal and equal care services.

Self-reported physical health among older surrogate parents to children orphaned and affected by HIV disease

Around the globe, older relatives, largely grandparents, have become the surrogate parents to children and adolescents orphaned by parental death from HIV/AIDS and to those whose infected parents are too ill to serve as their primary caregivers. Largely invisible to research, programme and policy initiatives, these older surrogate parents face compounded stress and the risk of neglected and compromised health. An exploratory study of third- and fourth-generation relatives (n=20, mean of 59 years) found an average of 3.3 chronic health conditions. Fifty-five per cent rated their own health as "fair" or "poor" and 70% reported having insufficient time to attend to their own health. Supportive services are needed to address the health needs of these "hidden patients".