Journal of Aging & Social Policy最新文献

With the expected rise in unpaid caregiving, many caregivers will have to combine care with employment. While most research finds negative spillovers between caregiving and employment, it is crucial to understand the factors under which caregiving has positive spillover effects. Analyzing Dutch retrospective data from the Longitudinal Internet Studies for the Social science (3,543 caregiving situations of 2,042 caregivers), this study examined how factors from the work environment and the caregiving situation are related to two positive spillovers, namely learned skills from caregiving for paid work and employment being a relief from caregiving. Results from multilevel models show that a working environment with high flexibility compared to no flexibility was related to more skill learning and relief. Further, we found that more understanding of managers and colleagues was related to learning skills, while managers and colleagues knowing about caregiving was linked to feeling relief. More diverse caregiving tasks were associated with more skills learned for paid work and more relief felt. These findings can guide state or firm-based policies to not only prevent negative but also foster positive spillovers.

Aging well has become a critical topic among scholars and policymakers in the context of global population aging. In Australia, the growing aging population underscores the need for a comprehensive index to measure successful aging. However, challenges such as data limitations, contextual constraints, and the lack of a unified social consensus have hindered efforts to establish nationwide measurements. Inspired by the European Union's Active Aging Index and employing a consistent theoretical framework and calculation method, this paper develops an Australian aging well index comprising 21 indicators across four domains. The constructed index offers valuable insights into Australia's strengths and weaknesses in supporting older adults, while also enabling comparative evaluations across nations. Australia demonstrates strong performance in the domains of Independent, Healthy and Secure Living, and Capacity and Enabling Environment; however, improvements are needed in Employment and Social Participation and Relationships. Targeted policy interventions are recommended to enhance employment opportunities and promote social engagement, thereby fostering a more comprehensive approach to aging well.

Sustainability became a critical concern in the care sector during the COVID-19 pandemic. This article defines and discusses the economic, social, environmental, and technological dimensions of sustainability in long-term care (LTC) in the pandemic context to expand the sustainability discourses in aging and care research. Economic sustainability shifted focus beyond expenditure control to encompass adequacy and stability in LTC financing and service delivery systems. Addressing moral distress of staff in care provision and social cohesion inside care-providing organizations were emphasized during the pandemic in terms of social sustainability. Minimal focus on environmental sustainability highlights the need for increased environmental awareness in LTC policy. Technology increasingly underpins economic, social and environmental sustainability in care by promoting older adults' autonomous lives. The article also highlights the role of government in strengthening multi-faceted sustainability in LTC policy. Technology for sustainable care depends on governments' capability to alleviate structural inequities. Transparent and interactive relationships between care providers and governments, particularly with the private sector, are necessary to produce sustainable care.

The Age-Friendly Cities and Communities Questionnaire (AFCCQ) is a tool for assessing and contributing to improving the urban living conditions of older citizens. The objective of this research is to validate the AFCCQ for Portugal's language and culture (AFCCQ-PT). The psychometric validation was conducted through a quantitative, cross-sectional study with a sample of 242 participants, living in Coimbra. Confirmatory Factor Analysis supported a nine-factor structure for the AFCCQ-PT and demonstrated strong internal consistency. Coimbra performed best on Housing accessibility and worst on Outdoor spaces and buildings. The AFCCQ-PT is a reliable and valid tool, useful for urban planning and social policy-making.

Social isolation poses significant challenges for older immigrants, particularly those who face cultural and linguistic barriers in their country of settlement. Despite these challenges, little is known about how older immigrants facilitate social connections. This study draws from the Inclusive Communities for Older Adults project to explore how Mandarin and Punjabi-speaking older immigrants utilize physical and digital spaces to mitigate social isolation. Data from semi-structured interviews with 20 older immigrants in Calgary, Canada, was analyzed thematically using deductive and inductive approaches. Findings reveal that physical spaces, such as community centers, facilitate social connections and recreational activities among older immigrants while providing volunteering opportunities that enhance meaningful community engagement. However, challenges such as transportation barriers and harsh winter conditions limit access to these spaces, highlighting the need for more localized and accessible facilities. To overcome these challenges, participants relied on digital platforms to maintain social networks, plan activities, and engage in virtual bonding activities. This study underscores the importance of hybrid approaches integrating community-driven physical and digital spaces to alleviate social isolation in older immigrant populations. Hence, the study recommends culturally and linguistically responsive programming, digital literacy initiatives, and policy measures to improve accessibility and inclusivity of physical and digital spaces.

The growing older population in Israel presents unique challenges for the healthcare system, particularly within geriatric hospitals that cater specifically to older patients. As the demand for specialized care increases, it becomes crucial to better understand the communication dynamics within these institutions. This study aims to examine how regulatory frameworks reflect values, specifically the value of communication and responsiveness in geriatric hospital care. Hence, the study seeks to discover how regulations specify communication instructions in geriatric institutions. To achieve this, a thematic analysis was conducted, focusing specifically on communication as a key organizational principle. The research thoroughly examined over 150 regulations pertaining to geriatric treatment in Israel. The findings reveal that formalized rules and regulations significantly specify aspects of communication. The study highlights the alignment of communication strategies with personal values, suggesting that core values can serve as a framework for improving interactions among healthcare providers, patients, and their families. The findings underscore the need for healthcare policies prioritizing communication strategies in geriatric care. By doing so, policymakers can foster better care outcomes and responsiveness.

Enrollment in Medicare Advantage (MA) plans surpassed fee-for-service (FFS) Medicare beneficiaries in 2024. Still, little is known about how effectively these private plans impact Medicare beneficiaries' health and quality of life outcomes. The current study aimed to examine the associations of MA plans' characteristics with beneficiaries' health-related quality of life (EQ-5D) physical and mental health summary scores (PCS, MCS) using the Medicare Health Outcomes Survey (2015-2017). The study used two cross-sectional samples (2016 and 2018) and one repeated sample with baseline (2015) and follow-up (2017) data. I used propensity score matching analysis (PSM) and the instrumental variable approach to address the selection of MA plans. Findings suggest that PPO (Preferred Provider Organization) enrollment was significantly associated with higher EQ-5D, PCS, and MCS scores than HMO (Health Maintenance Organization) plans. Results from linear models with individual and time-fixed effects suggest that beneficiaries enrolled in PPO plans experienced an improvement in all three outcomes from baseline to follow-up compared to HMO plans. Other significant plan-level characteristics were plan enrollment, ownership status, and duration. Assessing health and quality-of-life outcomes is important for a better understanding how MA plans directly impact population health, the core of the value-based care model.

The COVID-19 pandemic highlighted the importance of infection control practices in skilled nursing facilities (SNFs). This study examined SNF administrator perspectives on implementing built environment strategies to manage and mitigate COVID-19 transmission into and within their facility. Semi-structured interviews with SNF administrators were conducted between July 2020-December 2021. Administrators emphasized (1) the effective implementation of built environment strategies for quarantine and isolation protocols, (2) facility-level modifications used to manage and mitigate COVID-19 transmission, and (3) the challenges posed by outdated or high-density building layouts. Insights from this study's findings suggest important considerations for SNF architectural modifications and design as a mechanism for infection control. Thoughtful SNF architectural planning and design are critically important for the long-term care industry to expand and successfully meet the future challenges of pandemics, severe weather events, and other public health emergencies.

Home- and community-based health services (HCBHS) play a crucial role in the management of chronic conditions and disabilities among older adults. This study identified patterns of unmet needs for HCBHS and determined the factors associated with these unmet needs using a nationally representative sample. Data derived from 9,358 older adults responding to the 2018 wave of the China Longitudinal Aging Social Survey. HCBHS included home nursing, in-home doctor visits, rehabilitation, assistive medical devices, and health lectures. Latent class analysis was used to identify patterns of unmet needs for HCBHS, and multinomial logistic models were used to determine the associated factors. Three unmet needs patterns were identified: no needs/met needs (68.4%), unmet needs (11.1%), and uncertain needs (20.5%). Experiencing pain, depression, self-rated health, higher health workforce density, and region were significantly associated with both unmet and uncertain needs. Furthermore, education, living in urban areas, type of social pension, instrumental activities of daily living, and heart disease were found to be associated with unmet needs, while age, marital status, and household income were associated with uncertain needs. The findings underscore the need to address unmet and uncertain needs, develop targeted interventions, and implement policies to support aging in place.

Self-Direction is a service delivery model rooted in choice, empowerment, and control over long-term services and supports that allows older adults to select their services and who provides them. States determine key Self-Direction characteristics including level of state commitment, services that can be self-directed, and employer and budget authority, which may affect access and use. This mixed-method study identifies cross-state differences in how states are allowing Self-Direction among the 60 fiscal year 2023 Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers that serve older adults using Framework Analysis and descriptive statistics. Framework Analysis resulted in three qualitative categories for analysis: description of program values, determination of capacity, explanation of authority granted to self-directing participants. Descriptive findings showed significant cross-state differences in Self-Direction design, with high variation in goals set for Self-Direction participation, projected spending on Self-Direction eligible services, and number of waiver services eligible for Self-Direction. Findings indicate significant variation in design of Self-Direction across 1915(c) waivers. Older adults' access to and experience with Self-Direction may be significantly influenced by their state of residence. States can use these findings to learn from other waivers and enhance their own design.