Scholarly Works, Center for Gerontology
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- What About Elders Who Have No Informal or Formal Support?Blieszner, Rosemary; Roberto, Karen A. (Virginia Tech, 2001-06-30)Telephone interview data from a representative sample of 2,034 rural elders showed that 26.3% had limitations in abilities to perform daily activities (cooking, walking, cleaning, driving, etc.). Of these, many received informal assistance from family and friends or formal help from community agencies. However, 64 persons who had needs received no routine assistance from anyone. What are the effects of lack of support on their well-being? What coping strategies do they use in relation to their needs for assistance with everyday tasks? These elders did not differ from the others on demographic characteristics or psychological well-being. They demonstrated both resilience in current coping strategies and potential vulnerability in terms of risk to their physical health and psychological well-being in the future. Community service providers must address unexpressed needs in order to prevent exacerbation of problems and must educate elders and their families about the availability of services.
- Well-being and Coping Strategies of Elders Without Informal SupportBlieszner, Rosemary; Roberto, Karen A. (Virginia Tech, 2001-08-25)Telephone interview data from a representative sample of 2,034 rural elders showed that 26.3% had limitations in abilities to perform daily activities (cooking, walking, cleaning, driving, etc.). Of these, many received informal assistance from family and friends or formal help from community agencies. However, 64 persons who had needs received no routine assistance from anyone. What are the effects of lack of support on their well-being? What coping strategies do they use in relation to their needs for assistance with everyday tasks? These elders did not differ from the others on demographic characteristics or psychological well-being. They demonstrated both resilience in current coping strategies and potential vulnerability in terms of risk to their physical health and psychological well-being in the future. Community service providers must address unexpressed needs in order to prevent exacerbation of problems and must educate elders and their families about the availability of services.
- Geriatric Chronic Pain: Issues and Challenges from the Research LiteratureGold, Deborah T.; Roberto, Karen A. (Virginia Tech, 2001-11)Researchers interested in chronic pain in older adults come from multiple disciplines; thus existing information about geriatric pain is widely scattered. To establish a foundation from which to construct future research and interventions for older women and men, we developed a comprehensive, multidisciplinary database of the chronic pain and aging literature published between 1990 and 1998. In this paper, we examined the focus of studies of chronic pain in later life, how chronic pain was assessed and treated, and the influence of chronic pain on older adults’ quality of life. A search of ten electronic databases that index scientific journals yielded 302 articles that focused on chronic pain in later life. Given the disproportionate number of women in many of the study samples, gender comparisons were not always statistically feasible. Because a limited number of studies report gender comparisons in older adults, it is difficult to determine whether older women's experiences with chronic pain are unique and require special attention from health care providers or whether the causes, treatments, and consequences of chronic pain should be considered universal to the older population as a whole.
- Spending Behaviors of Older Women Living in an Assisted Living FacilityMcClung, Mary E. (Virginia Tech, 2002-03-02)A major demographic trend in the United States is the increasing older adult population. According to the US Census, the number of persons, ages sixty-five and older has increased approximately 4 million in 2000 and will continue to grow. As the baby boom generation reaches retirement, one issue facing older adults is how to assess and manage their housing and living expenses. An option for older adults that need some support, but are not totally dependent on others for their care is assisted living facilities. There is little public awareness about the cost associated with this housing option. The purpose of this study is to examine the monthly expenditures of older adult women living in an assisted living facility located in rural southwest Virginia. Interviews with the women identified spending patterns and the actual living expenses beyond the base rate residents pay each month. The findings highlight the array of expenses for older adult women living in an assisted living facility.
- Elderly & Disabled Waiver Services: What Do We Know About Providers?Glass, Anne; Roberto, Karen A.; Teaster, Pamela B.; Brossoie, Nancy (Virginia Tech, 2003)Little is known about home and community based services (HCBS) and even less about the quality of those services. As part of a “Real Choice Systems Change” grant received by the Virginia Department of Medical Assistance Services, the Center for Gerontology at Virginia Tech conducted a survey of agencies providing HCBS under the Medicaid Elderly and Disabled (E & D) Waiver. A written survey was sent to 160 providers across the state, based on a sampling plan designed to ensure representation of all planning districts and services mixes. Seventy surveys were returned for a response rate of 44%.
- Community Connections and Sense of Community among Older AdultsBrossoie, Nancy; Mancini, Jay A.; Roberto, Karen A.; Blieszner, Rosemary (Virginia Tech, 2003)The goal of this exploratory study is to identify what factors predict sense of community in older adult community members.
- Predicting Community Connections in the WorkplaceMancini, Jay A.; Roberto, Karen A. (Virginia Tech, 2003-11)This study explores the relationships between interpersonal connections in the workplace and four dimensions of employee retention.
- Leavers And Stayers: An Ecological Analysis Of Determinants Of Employee Retention In Long-Term CareRoberto, Karen A.; Mancini, Jay A. (Virginia Tech, 2003-11)The understanding of issues related to staff retention in long-term care requires a systematic and holistic examination of the care environment. Guided by the joining of two theoretical perspectives, human ecology and community capacity, we compared workers’ responses to a series of questions designed to assess individual, family and community influences on worker retention. Data were gathered from 156 direct care and support services staff members employed at a 120-bed facility. Over an 18-month period, 53% of the employees left the facility. Compared to employees who remained at the facility, those who left were significantly more likely to be younger, have a lower family income, and report feeling less prepared for the responsibilities associated with their job, less of a sense of work community connections, and less collective competence. No significant differences were found in the responses of the leavers by job position. Within positions, nurses who left reported significantly more family worries than those who stayed. CNAs who left were significantly younger than those who stayed. For support staff (i.e., dietary, housekeeping), leavers reported less work community connections, were less prepared for their jobs, and were less commitment to their jobs. Employment intentions for employees who left were explained by job match, job commitment and feeling rewarded. Employment intentions for employees who stayed were explained by family support, community connections, and employment-based outcomes. Findings suggest that multiple contextual and community-oriented factors influence retention of nursing home staff, and ultimately the quality of care of older adults.
- Rural Older Adults’ Previous Help and Support Experiences: Influences on Attitudes about Current and Future AssistanceBlieszner, Rosemary; Roberto, Karen A.; Love-Norris, Denise; Rogers, Sharon; Fruhauf, Christine A. (Virginia Tech, 2003-11)We investigated the extent to which earlier life experiences with informal and formal services might influence older adults’ views of getting assistance in the future. In a short-term longitudinal follow up of telephone interviews with a representative sample of rural, community dwelling elders (N = 532), we conducted face-to-face interviews with a subsample (n = 84) who were originally receiving informal assistance only, formal services only, both forms of support, or no assistance. We examined changes in assistance over 18 months and inquired about previous and current use of community resources (restaurants, hired help, overnight travel), home-based nursing or personal care, and formal services, as well as plans for future care needs. Past and current acceptance of external (nonfamilial) sources of support are associated with willingness to rely on formal services in the future. However, most participants expressed a strong preference for maintaining as independent a lifestyle as possible, even while expecting a need for greater assistance in the future. Whereas a minority have made arrangements for some type of formal care such as long term care insurance or nursing home placement, most intend to rely on family members for help. Few endorse depending on friends, neighbors, or other informal helpers except for occasional assistance. The results of this study have implications for research and public education on family caregiving, as well as for planning and delivery of informal and formal community services in rural areas.
- Rural Older Women’s Experiences with Chronic Health Problems: Daily Challenges and Care PracticesRoberto, Karen A.; Gigliotti, Christina; Husser, Erica; Kemp, Audrey June (Virginia Tech, 2004)Living with chronic diseases and their manifestations affects daily functioning and influences the quality of life of older women. This study, guided by the integration of life-course theory and a trajectory model of chronic illness, examines health care practices and management strategies that women with multiple chronic conditions incorporate into their daily lives. Responses to a telephone interview with 268 community-dwelling rural older adults (M age = 77 yrs., S.D. = 5.40) and qualitative interviews with 58 of the women from the larger sample were analyzed to examine the functional, psychological, and social consequences of their health. The women reported an average of 3.5 chronic conditions; the most common were arthritis (68%), heart disease (57%), osteoporosis (41%), and diabetes (31%). Findings suggest that the women played an active role in shaping the course of their illness within the context of their everyday living situations. One condition typically predominated their lives; however, regardless of the type or severity of their conditions, the importance of maintaining independence and autonomy was strongly emphasized by the women. Pain often contributed to functional limitations associated with their health conditions and frequently precluded or interfered with their completion of daily activities. To compensate for these changes, many older women slowed down the pace and number of activities they performed. Although they appreciated support from members of their social network, they infrequently turned to them for assistance. Consideration of personal and social variables that influence the life experiences of older women managing multiple health problems warrants continued investigation.
- Assuring Quality Care: Exploring Strategies of Medicaid E&D Waiver ProvidersBrossoie, Nancy; Roberto, Karen A.; Teaster, Pamela B.; Glass, Anne (Virginia Tech, 2004)Implementing quality assurance (QA) programs in unregulated noninstitutional settings remains a challenge for home and community-based service providers. A sample of 65 Elderly & Disabled (E&D) Waiver providers in Virginia were presented with eight problem scenarios commonly found in home-care services. Each of the respondents was able to identify strategies they would use to recognize and address each problem. Findings suggest providers currently use multiple mechanisms as part of their overall QA program. Discussion focuses on the strengths of using multiple approaches and on increasing provider awareness of complementary QA strategies and reducing the reliance on staff report as a major QA strategy.
- Influences on Psychological Well-being for Elders Receiving Family AssistanceBlieszner, Rosemary; Roberto, Karen A. (Virginia Tech, 2004-07-24)We investigated the effects of personal and social resources on the psychological well being of 359 rural older adults living in their own homes with some functional limitations and receiving assistance from relatives or friends. Personal resources included health, importance of religion, endorsement of filial responsibility norms, and attitudes toward community services. Social resources were number of informal helpers, frequency and duration of receiving assistance, emotional closeness to helpers, availability of someone to check on the elder, and having someone to trust and confide in. Depression, 4 Ryff subscales, self-esteem, and quality of life were markers of psychological well being. The findings indicate that the interactional aspects of receiving help are not particularly influential on the elders’ well being. Rather, in the context of receiving informal support, their personal characteristics have fundamental impact on their happiness. This implies that the informal help that elders receive does not threaten their sense of self.
- Personal and Social Resources and Well Being among Informal Care RecipientsBlieszner, Rosemary; Roberto, Karen A. (Virginia Tech, 2004-07-31)Moving beyond a focus on primary caregivers only, we examined the effects on older adults’ psychological well-being of having multiple family or friend helpers and of other elements of social support when receiving informal assistance. This research is grounded in a model of well being (Fisher et al., 1983) positing that most aid situations contain a mixture of positive and negative elements. If receiving help highlights inferiority or dependency, aid will be viewed as self-threatening; if assistance avoids contributing to negative self-images, it will be seen as self-supportive. Values held about support and dependency affect reactions to aid, as do social resources manifested in the helping situation. Data, from 359 community-residing elders, include 6 personal resources, 6 social resources, Depression (CES-D), 4 Ryff Well Being subscales, Rosenberg Self-esteem, and Quality of Life. Regression models explained between 9% and 28% of variance in indicators of psychological well being. Findings suggest that the social context of receiving help is not particularly influential in well being, but personal characteristics have fundamental influence on happiness. Informal assistance does not threaten sense of self.
- Caregivers of Persons with Mild Cognitive Impairment: Information and Support NeedsWilcox, Karen L.; Roberto, Karen A.; Blieszner, Rosemary; Winston, Brianne L. (Virginia Tech, 2004-11)One of the newer concepts of age-related memory deficit is mild cognitive impairment (MCI). MCI reflects self-reported changes in cognitive function that do not necessarily interfere with work or social relations; it is viewed as a transitional phase between normal cognitive aging and dementia. Researchers and practitioners lack a comprehensive understanding of what relatives of persons with MCI are actually experiencing and what they realistically believe would be helpful to manage their situation now and in the future. In a multi-method, mini-longitudinal design that incorporated quantitative and qualitative approaches, we collected information from patient charts and semi-structured family interviews to investigate the information and support needs of 20 (out of 100 to be interviewed) family members of older adults with MCI. We found that, apart from information available about potential later diagnoses such as dementia or Alzheimer’s disease, families reported having little information available to them to assist in decision making and caregiving for early stages of memory loss. Family members were hesitant to think about and plan very far into the future and were more likely to take things a day at a time. Past experiences with family members or friends with memory difficulties or other serious health conditions enabled some family members to feel more at ease and knowledgeable with the process of seeking help for themselves and the older adult they were supporting. Findings suggest that earlier identification of memory loss has implications for clinical practice and the delivery of health care and social services to older individuals and their relatives.
- The Influence of Mild Cognitive Impairment on Marital RelationshipsWinston, Brianne L.; Roberto, Karen A.; Blieszner, Rosemary; Wilcox, Karen L. (Virginia Tech, 2005)Background: Mild cognitive impairment (MCI) signifies age-related memory decline that is less severe than with dementia. Most scholarship focuses on the clinical diagnosis and prevalence of MCI; the psychosocial aspects have been studied less often. Thus the purpose of this research was to examine the influence of MCI on interactions among long-term married couples. Methods: Using qualitative methodology, 10 spouses (5 wives, 5 husbands) of community-dwelling persons diagnosed with MCI reported on shared couple activities, amount of time spent together, division of household tasks, and management of everyday life. Transcripts were analyzed through an open coding process and results are represented by case studies. Results: The interviews revealed both stability and change within marital relationships when spouses are faced with MCI. Emergent themes focused on relational interactions (e.g., disclosure, negative and positive emotional outcomes, shared activities), relational dynamics (e.g., power, “couplehood”), socio-emotional intimacy (e.g., companionship, support, concern), and household responsibilities (e.g., external help, equal division of labor, spouse assumes most responsibility, person with MCI has assigned duties). Conclusions: Findings indicate that dealing with a spouse with MCI yields difficult emotional responses including helplessness, frustration, sadness, and worry. Spouses also expressed positive outcomes (e.g., commitment, love, emotional closeness) when discussing their relationship with their partner. Additional research is needed on the most effective coping strategies in the face of an uncertain prognosis and perceived changes in marital interactions. Practitioners should attend to the unique stressors and strains of having a spouse impaired by early memory loss and the potential for changing marital dynamics.
- Grandfamilies: Parenting Satisfaction and Family FunctioningDolbin-MacNab, Megan L.; Sanford, Nicole M.; Rodgers, Brandon E.; Stewart, Shelley K.; Finney, Jack W.; Roberto, Karen A. (Department of Human Developmen, Department of Psychology and Center for Gerontology, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, 2006-10)Previous research has demonstrated that grandparent caregivers experience high levels of physical, psychological, and relationship stress. However, few studies have examined how psychosocial and relationships. perspective, this exploratory study examined predictors of parenting satisfaction and family functioning among 40 grandmothers raising grandchildren. Parenting satisfaction was associated with lower levels of financial burden and better family functioning. More optimal family functioning was associated with higher parenting satisfaction, more social support, and grandmothers’ mental health (i.e., less depression and anxiety). Unexpectedly, higher financial burden was also associated with better family functioning. Findings suggest that the quality of custodial grandmothers’ family relationships is influenced by both individual and contextual factors. However, because social support and financial burden had the strongest influence, practitioners should pay particular attention to the impact of contextual factors on the quality of relationships within grandparent-headed families.
- Surviving Hurricane Katrina: Resilience and Resources of Aging FamiliesRoberto, Karen A.; Henderson, Tammy L.; Kamo, Yoshinori (Center for Gerontology and Dept. of Human Development Virginia Polytechnic Institute and State Universi, 2006-11)
- Research on Persistent Pain in Late Life: Current Topics and ChallengesHolland, Alissa Kate; Roberto, Karen A.; Perkins, Susan N. (Developmental and Biological Psychology, Virginia Tech, 2006-11)
- “It Was Like An Elephant Sitting on My Chest”: Older Women’s Experiences With Coronary Heart DiseaseHusser, Erica; Roberto, Karen A. (Center for Gerontology and Dept. of Human Development, Virginia Polytechnic Institute and State University, 2006-11)
- Family Perceptions of Mild Cognitive ImpairmentRoberto, Karen A.; Blieszner, Rosemary (Center for Gerontology, Virginia Tech, 2007-11)