Journal of Aging & Social Policy最新文献

Turkey's aging population and rising care needs highlight the urgency of addressing unmet needs in daily and instrumental activities (I/ADL). Using nationally representative 2016 Turkish Health Survey data, this study examines the prevalence of unmet I/ADL needs and associated risk factors among community-dwelling older adults aged 65 and older. Findings reveal a high prevalence of unmet needs, particularly for bathing, shopping, and housework. Unmet I/ADL needs are most common among older adults who are women, not married, more advanced in age, have lower education levels, lack pension income, live with chronic illnesses, and report poor health. High unmet I/ADL needs reflect broader gaps in care provision for older adults living in the community, necessitating reforms in institutional and home and community-based services, pension and financing mechanisms, and workforce capacity to ensure equitable service provision. These findings underscore the need for equitable, culturally responsive solutions to inform sustainable care frameworks for Turkey and similar familialistic societies.

Depression reduces the quality of life of older adults with disabilities, adversely impacting the healthy aging of the global population. This study examined whether social participation and self-rated health play a chain mediating role between socioeconomic status and depressive symptoms in elderly people with disabilities. The data were derived from the Chinese Longitudinal Healthy Longevity Survey (n = 1,354). Results indicate that total family income had a direct impact on depressive symptoms (β = -0.220, 95%CI: -0.417, -0.022) and an indirect impact through social participation (β = -0.040, 95%CI: -0.081, -0.009) and self-rated health (β = -0.149, 95%CI: -0.246, -0.055), with a significant serial mediation effect (β = -0.022, 95%CI: -0.040, -0.007). Policies should prioritize integrated delivery of economic support, social-participation facilitation, health security, and comprehensive services to provide targeted assistance to low-education disabled oldest-old adults, and should actively foster their sustained societal engagement through community-based, barrier-free, and low-tempo activity designs.

With the rise in aging populations worldwide, research focused on older adults has expanded significantly across multiple disciplines. This study presents a comprehensive analysis of the global research landscape on aging, highlighting key contributing countries, major research themes, and emerging trends. Using Latent Dirichlet Allocation (LDA) topic modeling, a large corpus of research articles related to aging populations, published between 2000 and 2023 and retrieved from the Scopus database, was examined. The data were divided into four six-year periods to observe the progression and shifts in research focus over time. Fourteen broad research categories were identified, with early studies heavily centered on health and medical issues. However, in more recent periods, there has been a noticeable shift toward promoting the overall well-being of older adults. This includes growing attention to technological innovations, mental health, social support systems, and the development of age-friendly environments. Additionally, countries such as South Korea and China have demonstrated remarkable growth in both their aging populations and their research contributions - particularly in technology-related fields. These findings underscore the importance of a more integrated and forward-thinking policy approach - where health remains vital, but quality of life is gaining prominence in aging-related agendas.

The effect of social security benefits on the relationship between instrumental activities of daily living (IADL) disabilities and subjective well-being remains unclear. This study explored the impact of baseline IADL on subjective well-being trajectories among older adults in China with the moderating role of social security benefits. Data derived from four waves of the Chinese Longitudinal Healthy Longevity Survey (n = 1,732 older adults). Multinomial logistic regression analyses were conducted with subjective well-being trajectories categorized as high, moderate, and low, stratified by the level of social security benefits (generous, moderate, none) for subgroup analysis. Results indicated none of participants in the generous social security benefits group followed a low social well-being trajectory and baseline IADLs showed no significant impact. By contrast, baseline IADLs predicted moderate and low social well-being trajectories in the moderate social security benefits group. Baseline IADLs predicted only a moderate social well-being trajectory in the group without any social security benefits. Findings highlight the effects of IADL disabilities on subjective well-being trajectories and social security benefits can mitigate this negative impact.

Family caregivers play a crucial role in supporting individuals with chronic and life-limiting illnesses, disabilities, age-related conditions, and mental health challenges. Yet taking on this role is often made without deliberation or consent. With over 63 million family caregivers in the United States, there is little discussion of how to engage current and future caregivers in a structured, informed decision-making process about the role and related responsibilities. While informed consent is a foundational principle in medicine designed to foster individual patient autonomy, it is seldom applied to caregiving decisions, leaving many unprepared for the role. Healthcare professionals are in a unique position to address this issue. This paper advocates for a shift toward informed decision-making in family caregiving, ensuring individuals can make choices that are informed and voluntary. This approach will lead to better-informed family caregivers and a more ethically focused healthcare system.

As the global population ages, age-friendly communities are becoming a priority. However, most initiatives have an urban bias, overlooking the unique challenges in rural and remote areas. These regions, experiencing high rates of population aging due to youth out-migration, older adults aging in place, and retiree in-migration, often lack the resources and infrastructure to support aging in place, with gaps in long-term care exacerbated by geographic isolation. This study focuses on Lāna'i, Hawai'i to explore the challenges in providing long-term care to older adults in remote areas. By engaging older adults, caregivers, and service providers, it examines the factors essential for their wellbeing, and how remote communities can support aging in place. The study highlights the importance of community assets like social connectedness, leadership, and advocacy in overcoming resource constraints. At the same time, it reveals gaps in long-term care, especially during extreme events like the COVID-19 pandemic, and emphasizes the need for context-specific, community-driven solutions for better healthcare coordination, investment in infrastructure, and specialized services. Findings underscore the need to integrate local efforts with broader political and policy changes to improve age-friendliness so that remote communities are not disadvantaged in resource allocation.

Despite growing investment in age-friendly models and social prescribing, many older adults remain disconnected from services, even when those services align with identified needs. Findings from the Age-Friendly Integrative Mobile Services (AIMS) pilot indicate that this engagement gap (motivational barriers, relational mistrust, and value misalignment) is as limiting as access or infrastructure. Motivational engagement - defined as aligning care with a person's values, readiness, and trust - emerged as a critical yet overlooked driver of uptake. Centering trust, values alignment, and relational support within implementation strategies may enhance service uptake, sustain engagement, and improve equity in aging-in-place outcomes by ensuring care is both accessible and meaningful.

A dementia-friendly community (DFC) is a place where people living with dementia (PLWD) and family carers' rights are supported and communities value their input. Many developed countries have social policies to address the discrimination and stigma faced by PLWD and to support their interest in continuing to live in their homes and communities. This exploratory, micro-ethnographic case study research examined micro-processes in two committees established to build DFCs in Australia. Data were derived from participant observation, field notes, and 16 interviews with DFC committee members. Findings highlight two key learnings. First, active engagement requires meeting the rights of PLWD to have a voice, be heard, and hold power in committees. Second, recognizing how positioning PLWD as consumers or leaders affects participation and inclusion. From our analyses and insights gained, we propose how a dialogical community development approach could improve local initiatives through interpersonal relationships and actions as well as explicit reflection and discussion of how professionals can facilitate or constrain inclusive and participatory practices among PLWD.

Home care can be costly and time consuming to provide, and there is often limited public financing available to those with care needs. As a result, many adults experience unmet need and/or gaps in home-care support. This is particularly acute during times of austerity when budget constraints further limit public spending. This study examines determinants of unmet need for home-care support among adults over 50 in England and Ireland during the Great Recession. Using data from the English Longitudinal Study of Aging and the Irish Longitudinal Study on Aging, we examine factors associated with unmet need, including the role of public financing. Findings reveal notable differences in the proportion reporting unmet need in England (38.0%) versus Ireland (66.1%). Wealth offered no clear protection against unmet need in either nation. Results regarding physical and cognitive vulnerabilities were mixed: In Ireland, activity limitations were linked to greater probability of unmet need. In England, poorer cognitive function was associated with lower probability of unmet need. Understanding the impact of public financing on unmet need during times of economic uncertainty is critical for evidence-based policymaking. Improved harmonization of international aging data is essential to support comparative analyses and facilitate international learning opportunities.

Residential care facilities in China often prioritize material needs over emotional well-being, leaving gaps in understanding psychological adaptation processes. This study aimed to explore the dynamic process by which older adults adapt emotionally to residential care facilities, focusing on how their needs and stressors evolve over time. Using a grounded theory methodology, semi-structured interviews were conducted with 30 residents from a large residential care facility in China, with data analyzed through open, axial, and selective coding. Findings revealed a three-stage adaptation process: (1) The adaptation stage, driven by security needs and familial burden reduction, where older adults primarily seek a comfortable environment; (2) The integration stage, addressing loneliness and fostering collective belonging, where older adults primarily seek to establish connections with others properly; and (3) The sublimation stage, focusing on self-identity, autonomy, and social value, where older adults primarily seek to find value and meaning in the remaining life. Emotional needs and stressors evolved dynamically across stages, reflecting shifts from external pressures to internal self-actualization. The study underscores the need for residential care facilities to adopt stage-specific interventions - ensuring safety, promoting group cohesion, and enabling self-directed engagement - to support holistic well-being and positive aging in China's rapidly aging society.