This research sought to determine the impact of the Older Americans Act of 1965 and its subsequent amendments on the ages population in Portland-Multnomah County from 1965 to 1977. After a comparative analysis of ages services prior to the Act of 1965, and the elderly services subsequent to the Act, the conclusions revealed that there was a significant impact made upon the lives of seniors in Portland-Multnomah County area.

In the literature, the experience of ‘care’ and ‘caregiving’ has been well documented and widely researched. Caregivers are recognized as people (family and friends) who provide unpaid substantial care for family members. Over time, research has increased awareness of caregivers as a distinct social group and has also contributed to caregiving being a widely recognized social issue. However, despite this increased awareness and continued concern for caregivers, much of the literature focuses on adult caregivers. As a result, the experiences of other caregiving populations, such as the youth and young adults, continues to be overlooked and underrepresented. Therefore, there is a need to explore and understand the unique experience of this population and how they give meaning to their experiences. Young caregivers (YCs) are children (5-18) and young adults (18-25) who provide substantial (unpaid) care for a family member who has an illness or disability (Stamatopoulos, 2016). Research on this population is scant and there exists many notable gaps in the literature in terms of diversity, age-based differences, programming and best practices for intervention. More specifically, there is a gap in understanding the experiences of young caregivers who are affected by progressive and incurable chronic brain diseases such as Alzheimer’s Disease or a Related Dementia. As such, this dissertation explores the experiences of YACs affected by ADRD, in terms of their personal experiences with ADRD (knowledge, dementia care and care practices), perceptions of their caregiving role and how they navigate the caregiving role. It builds on scholarship on young caregivers to broaden existing knowledge by using a phenomenological approach, known as Interpretive Phenomenological Analysis, to explore their caregiving experiences and the meaning they give to these experiences in-depth (n=12). It also aims to challenge the dominant assumptions about young caregivers by giving voice to this population by situating the young caregivers as the experts in their own lives. Findings indicate that the caregiving experience for YACs is complex, and situated within a larger socio-political context, which impacts the overall experience of care. Overall, the findings contribute to knowledge on the experiences of care among YACs and highlight the need for more inclusive research and practices on addressing caregiving among this group. / Dissertation / Candidate in Philosophy / This dissertation explores the lived experiences of young adult caregivers (YACs) caring for an older adult with Alzheimer’s Disease or a Related Dementia. Research on this group of caregivers is limited, particularly YACs (ages 18-25) who provide substantial (unpaid) caregiving for an older adult affected by Alzheimer’s or a Related Dementia. Therefore, a key aim of this research is to generate awareness and shed light on the nature of caregiving as experienced by this overlooked population of caregivers. As such, this dissertation aims to understand how young caregivers give meaning to, interpret and make sense of their caregiving experience. To understand the caregiving experience of YACs, I conducted interviews with 12 YACs from Canada and the United States and analyzed their perspectives in detail. The findings shed light on the many factors that shape the caregiving experiences. In addition, the findings show that more research is needed to understand the differences amongst young caregivers to better support their needs. In general, the research can contribute to existing knowledge on young adult caregivers, as well as relevant programs and policies.

No description available.

Våld i nära relation är ett utbrett och komplext problem i dagens samhälle. En del av våldet som ofta glöms bort är det våld som sker i äldres nära relationer och detta ses ofta som en egen kategori: våld mot äldre. Äldre kvinnor som utsätts för våld i nära relation är speciellt ett problem som riskerar att förbises. Denna uppsats har undersökt hur konstruktioner av våld i nära relation samt äldres våldsutsatthet görs i svenska kommuners policydokument i arbetet mot våld i nära relation. Syftet har varit att analysera dessa konstruktioner utifrån ett intersektionellt perspektiv för att se om intersektionen mellan kön och ålder synliggörs i policydokumenten, alltså om den äldre kvinnans dubbla utsatthet ryms i dessa dokument. För att analysera policydokumenten användes Carol Bacchis policyanalysmetod What’s the problem represented to be?. Metodens teoretiska grund med avstamp i ett socialkonstruktionistiskt perspektiv har även varit en del av uppsatsens teoretiska utgångspunkt. Resultatet visar att majoriteten av de undersökta kommunerna framställer våldet som ett könsneutralt problem. Undersökningen visar även att äldres våldsutsatthet till viss del förstås som en del av problemet våld i nära relation. Dock ses våld mot äldre i första hand som en konsekvens av den sårbarhet som ökad ålder kan innebära. Den äldre kvinnan var i princip obefintlig i policydokumenten, det saknas således ett intersektionellt perspektiv där den specifika risken med att vara just kvinna och äldre framkommer.

This dissertation explores how family and marriage relationships vary according to the culture in which they occur. Based on the individualism/collectivism framework about cultural variations in familial beliefs across countries, I study three topics of family and marriage relationships across cultures. In the first study, I examine how 17 member countries of Organisation of Economic and Co-operation and Development (OECD) differ culturally in older adults' preference for family elder care. I find that older adults from countries with more traditional values that emphasize the importance of a strong parent-child tie are more likely to prefer family care rather than formal care than those from more secular-rational countries with less emphasis on the parent-child tie; the cultural difference gets smaller at a higher level of individual family income. In the second study, I select China as a representative of the collectivist culture, and look into how the collectivist culture and older parents' filial beliefs shape the intergenerational relationship in China. I find that patrilocal and patrilineal traditions are still prevail in China. A highly cohesive intergenerational relationship people idealize in the collectivist culture is more common between older parents and married sons, and least common between older parents and married daughters. In the third study, I compare an individualist society, the U.S., and China, a collectivist society to test whether marriage also isolates people from their informal social network in China as observed in the U.S. I find that marriage does not isolate but integrates people into their informal social network in China, while marriage isolate people in the U.S. The three studies present new evidence on how marriage and family experiences differ due to different cultural beliefs about family, and under what conditions the cultural influences are weakened or reinforced. / Ph. D. / People tend to think and behave according to their individual cultural beliefs and value system and influenced by the cultural environment they live in. Three studies in this dissertation examine how the macro cultural environment and individual beliefs about the family and family relationships influence 1) the preference for family elder care in 17 countries in Europe, North and South America, and East Asia; 2) the intergenerational relationship in China; and 3) the marriage effect on socializing with friends, neighbors, and relatives in the collectivist China and the individualist U.S. In the first study, I find that the preference for family elder care is stonger among older adults from more traditional countries that value family traditions and strong parent-child ties than those from countries with less emphasis on family traditions and the parent-child tie. The cultural influence gets weaker as older adults’ family income increases. In the second study, I find that intergenerational relationship is still very traditional in China. A highly cohesive relationship idealized in the collectivist culture is more common between older parents and their married sons, and least common between older adults and married daughters. In the third study, I find that, compared to the never married and the previously married, married Chinese do not socialize less often with friends, and tend to socialize more often with neighbors and relatives. However, married Americans socialize less often with all these three groups of people in their informal social network than the unmarried. All three studies present new evidence on how marriage and family experiences differ due to different cultural beliefs about family, and how the cultural influence would change according to individuals’ social conditions.

人口快速老化與平均餘命的延長，使我們越來越重視老年退休生活，加上高齡者健康、經濟資源的提升，與家庭支持系統轉弱等現代社會特性，鼓勵高齡者從事社會參與乃成為老人福利中的重要課題。台灣地區高齡者從事社會參與的情形為何？影響高齡者從事社會參與的因素有哪些？從事社會參與是否能提升生活滿意度？究竟哪種社會參與面向才是主要影響生活滿意度的因素？均是本研究關注的焦點。首先根據文獻探討高齡者生活滿意度及社會參與的意涵、相關因素與相關研究，並以社會老年學觀點作為本研究的理論基礎。 本研究乃是使用行政院衛生署國民健康局人口與健康調查研究中心執行之「臺灣地區中老年身心社會生活狀況長期追蹤調查系列」1999年調查資料進行次級資料分析，研究樣本為年滿六十五歲以上之高齡者，有效樣本數為2890人，針對所得的資料，以描述統計、單因子變異數分析、卡方檢定、獨立樣本t檢定、點二系列相關、皮爾森積差相關、邏輯迴歸、多元迴歸分析及階層迴歸分析等統計方法進行分析。綜合本研究主要發現，獲致下列結論： 一、高齡者具有社會參與的需求。 二、參加「老人團體」是高齡者社會參與的最愛。 三、意向障礙是阻礙高齡者社會參與的主因。 四、高齡者的社會參與與生活滿意度有關。 五、社會參與面向中，影響生活滿意度最關鍵的因素為「參與程度」。 六、影響高齡者社會參與的因素為，性別、年齡、教育程度、經濟狀況、健康狀況、居住地。 七、影響高齡者生活滿意度的因素為，教育程度、經濟狀況、健康狀況、婚姻狀況、居住安排及有無社會參與。 八、影響有社會參與的高齡者生活滿意度的因素為，教育程度、經濟狀況、健康狀況、居住安排及參與程度。 根據上述研究結論，本研究分別就政府機關、辦理老人社會參與相關機構及高齡者本身提供以下建議：一、對政府機關之建議：(一)健全老人經濟及健康之福利服務；(二)透過社會教育的方式，向老人宣導社會參與對老化調適的好處；(三)廣設老人活動中心，鼓勵並協助老人組成社團；(四)營造高齡者社會參與的無障礙環境。二、對辦理老人社會參與相關機構之建議：(一)排除機構障礙，增加高齡者社會參與的機會；(二)提供多元的社會參與類型，並注重活動進行的品質。三、對高齡者本身之建議：(一)破除意向障礙，積極從事社會參與；(二)從事退休準備，以擁有健康、滿意的老年生活。 / Due to the rapid aging of population and the prolongation of life expectancy, people pay more and more attention on elders’ retirement life. According to the characteristics of modern society, such as elders’ health, increase of economic resources and the obsolescence family support system, encouraging elders to have social participation becomes an important issue of elderly welfare. How is elders’ social participations in Taiwan? What are the key factors of elders’ social participations? Could social participation increase their life satisfactions? Which of the social participation is the main factor that influences life satisfactions? Above are the targets of this study. At first, we probe into life satisfactions, social participation meanings, related factors, and research from bibliography, and we take social gerontology as the theoretical base of this study. This study conducted a secondary data analysis based on the data from 1999 Survey of Health and Living Status of the Middle Aged and the Elderly in Taiwan, provided by the Bureau of Health Promotion, Department of Health, R.O.C. (Taiwan). The study subjects were elders over 65 years old, and the number of valid samples was 2890. The data were analyzed with descriptive statistics, one-way ANOVA, Chi-square test(X2), Independent-Samples t-test, point biserial correlation, the Pearson product-moment correlation, logistic regression analysis, multiple regression analysis and hierarchical regression analysis. Based on the main findings of this study, we have the following conclusions: 1.Elders have needs of social participation. 2.“The elderly group” is elders’ favorite social participation target. 3.Intention obstacle is the main reason hindering elders’ social participation. 4.Elders’ social participation is related to life satisfaction. 5.The most critical factor in social participation which influences life satisfaction is “participation degree”. 6.The factors influencing elders’ social participation are gender, age, educational level, economic status, health status and residential locations. 7.The factors affecting elders’ life satisfaction are educational level, economic status, health status, marital status, residential arrangement and social participation. 8.The factors affecting the life satisfaction of the elderly who has social participation are educational level, economic status, health status, residential arrangement and participation degree. According to the above conclusions, this study proposes the following suggestions for the governments, institutions dealing with elders’ social participation and elders: 1. Suggestions for the governments: (1) Complete elderly economic and healthy welfare services. (2) Promoting the advantage of social participation on aging accommodation to elders by social education. (3) Constructing elderly community centers, encouraging and helping elders to establish the associations. (4) Constructing the barrier-free environment for elders’ social participation. 2. Suggestions for the institutions dealing with elders’ social participation: (1) Eliminating the obstacles of the institutions to increase probability of elders’ social participation. (2) Providing diverse types of social participation and focusing more on the quality of the activities. 3. Suggestions for elders: (1) Overcoming the intention obstacles to have more social participation. (2) Being prepared for the retirement to have healthy and satisfying elderly life.

This qualitative study’s purpose was to investigate and compare the view towards activities for elders among the manager, employees and the elders at a nursing home. One manager, two employees and three elders participated in interviews. These interviews showed that the view towards activities among elders was generally positive. The informants stated that the activities contributed with several positive effects. Among them were the elders’ subjectively reported well-being. This indicated correlation between the results and activity theory, implying that activities are a vital part of elders’ well-being. When the informants were asked about the possibilities as well as obstacles of elders engaging in activities, economy and disease were, directly and indirectly, brought up as obstacles. Regarding the economy, the HR perspective but also new public management could serve as explanations. The largest possibility presented however was the employees; if they were passionate about activities, as would the elders also become. / Studien hade som syfte att undersöka och jämföra synen på aktiviteter för äldre bland verksamhetschef, personal och brukare på ett särskilt boende. En verksamhetschef, två personal samt tre brukare deltog som informanter i denna kvalitativa studie bestående av intervjuer. Dessa intervjuer visade att synen på aktiviteter är generellt positiv. Samtliga informanter uppgav aktiviteters positiva effekter, till exempel ett ökat välbefinnande för den äldre. Detta indikerar en korrelation mellan resultaten och aktivitetsteorin, vilken tyder på att aktiviteter är en viktig komponent i den äldres välbefinnande. När informanterna blev tillfrågade vilka möjligheter och hinder som fanns angående brukarnas deltagande i aktiviteter angavs ekonomi och sjukdom, både direkt och indirekt, som hinder av samtliga informanter. Vi tolkar dessa ekonomiska aspekter genom att använda oss av ett HR- samt new public management-perspektiv. Den största möjligheten som de alla uppgav var personalen; om de ansågs engagerade till aktiviteter, blev också de äldre det.

The aim of this study was to investigate how home care staff experience, detect and handle intimate partner violence among elders as well as investigate the level of knowledge they perceive they and the workgroup possess concerning intimate partner violence. The study was conducted through qualitative interviews with four home care staff. The main results showed that home care staff have difficulties detecting all forms of violence, the most common signs of violence they discovered were bruises, injuries and mean words. The staff experienced limitations in their professional role in relation to intimate partner violence and difficulties in knowing the boundary for what is considered violence. Education in the field is missing and the conception about the level of knowledge differed between the staff. The authors argue that there is a need for more education and knowledge to increase the possibility to detect intimate partner violence among elders. / Studiens syfte var att undersöka hur hemtjänstpersonal upplever, upptäcker och hanterar våld i nära relationer bland äldre samt undersöka vilken kunskapsnivå de upplever att de och arbetsgruppen innehar gällande våld i nära relationer. Studien genomfördes via kvalitativa intervjuer med fyra hemtjänstpersonal. De huvudsakliga resultaten visade att hemtjänstpersonal har svårigheter att upptäcka alla former av våld, de tecken på våld de märkte var blåmärken, skador och elaka ord. Personalen upplevde begränsningar i sin yrkesroll samt svårigheter i var gränsen för våld i nära relation går. Det saknas utbildning inom ämnet och uppfattningen om kunskapsnivån skiljde sig åt. Författarna argumenterar för att det behövs mer utbildning och kunskap för att öka möjligheten att upptäcka våld i nära relation bland äldre.

A formação de cuidadores de idosos da saúde pública deve ser considerada, atualmente, questão de grande relevância, num pais em que expressiva parcela da população não conta com recursos para enfrentar despesas que surgem a partir do envelhecimento. Esta capacitação deve incluir não apenas conhecimentos específicos em relação a cuidados corporais, mas também preparo de caráter psicológico, que permita a instauração de vinculação suficientemente saudável entre cuidador e idoso. Neste contexto, a presente investigação visa estudar empiricamente o imaginário coletivo de cuidadores de idosos profissionais da saúde pública a respeito da pessoa idosa. Concebida e realizada a partir do uso do método psicanalítico, em todas as suas etapas, esta pesquisa articulou-se ao redor de uma entrevista com cuidadores, durante a qual o Procedimento de Desenhos-Estórias com Tema foi usado como recurso facilitador da comunicação emocional, bem como da consideração de experiências vivenciadas, no cotidiano institucional, em situações formais e informais, junto a idosos, cuidadores e da equipe, constituída por profissionais de várias formações. O conjunto do material emergente permitiu a elaboração de duas narrativas transferenciais, a partir das quais seis campos de sentido afetivo-emocional, ou inconscientes relativos, puderam ser criados/encontrados: cuidar enobrece a alma, cuidado com esse velho!, mas eu sou de confiança!, perdendo a autonomia, empobrecendo a convivência e vontade de viver(?). A condição de idoso frágil gera impactos emocionais e os cuidadores são sensíveis aos delicados aspectos que ligam a dimensão relacional inerente ao cuidado do idoso. Os seis campos criados/ encontrados indicam, de modo suficientemente preciso, quais são as principais questões psicológicas em processos de capacitação de cuidadores de idosos: apresentar-lhes a dramática de vida do idoso frágil e prepará-los para lidar com as delicadas interações que este tipo singular de intimidade certamente vai gerar / The training of caretakers for the elderly in public health must be considered, nowadays, a matter of great importance, in a country in which a considerable part of the population does not have the means to handle expenses that come with aging. This training must include not only specific knowledge on physical care, but also psychological preparation which allows for the creating of a bond strong and healthy enough between caretaker and elderly citizen. In such context, this investigation aims to study empirically the collective imaginary of professional public health caretakers of the elderly regarding older citizens. Conceived and executed using the psychoanalytic method, in all its steps, this research was organized based on an interview with the caretakers, during which the Drawing-Stories with Theme Procedure was used a facilitating resource for emotional communication, in discussing experiences lived, in the institutional daily happenings, in formal and informal situations, together with the elderly, caretakers and the staff, which is constituted by professionals from several backgrounds. The resulting material allowed for the creation of two transferential narratives, from which six affective-emotional or relative unconscious, fields could be created/derived: care-taking ennobles the soul, take care around that old man/woman!, but I\'m trustworthy!, losing autonomy, crippling relationships and will to live(?). The condition of frail elderly citizen impacts emotionally and caretakers are sensitive to the delicate aspects that connect the relationship dimension inherent to taking care of an older person. The six fields created/found indicate, in a sufficiently precise manner, which are the main psychological issues in the training process of caretakers for the elderly: presenting them the dramatic life of a frail elderly citizen and preparing them to deal with the delicate interactions this singular kind of intimacy will certainly bring

Objetivo: O presente estudo investigou as respostas hemodinâmicas agudas da pressão arterial sistólica (PAS), pressão arterial diastólica (PAD) e frequência cardíaca (FC), imediatamente e nas 24 horas após o exercício, em idosas hipertensas, submetidas a 3 tipos de exercícios físicos e um momento controle (C). Métodos: Participaram do estudo 30 idosas hipertensas sob terapia medicamentosa. Todas as idosas foram submetidas aos protocolos de exercício aeróbio contínuo (AC), exercício aeróbio intervalado (AI), exercício resistido (ER) e a (C), com o intervalo mínimo de 7 dias para assegurar o efeito agudo de cada intervenção, em ordem randomizada. Todas as participantes foram submetidas previamente ao teste ergométrico, utilizando-se o protocolo de rampa devido a sua melhor acurácia para a população em estudo. A prescrição do AC e do AI foi feita por meio da frequência cardíaca máxima (FCM) obtida no teste. Na intervenção do AC foi calculada a frequência cardíaca de treinamento (FCT), com a intensidade de 70% FCM, com duração de 40 minutos de exercício. No AI foi utilizado a alternância de 80% da FCM no período de condicionamento, durante 2 minutos, e 60% da FCM, durante 2 minutos, para o período de recuperação, com duração de 40 minutos de exercício. O ER foi conduzido após obtenção de uma repetição máxima (1RM) em três exercícios para os principais grupos musculares: chest press, leg press e remada sentada e mais seis exercícios resistidos comumente utilizados para a prescrição do treinamento de força nas academias, utilizando o número de repetições adequadas por meio da escala de percepção subjetiva de esforço (PSE). A intensidade do ER foi de 50% de 1RM para dez repetições para o aquecimento específico e, após 1 minuto, a carga era ajustada para 70% de 1RM e realizava-se uma série entre 6 e 10 repetições para o condicionamento em todos os exercícios. Os valores da PAS, PAD e FC foram obtidos antes e após as sessões dos exercícios pelo método oscilométrico e, após cada sessão era realizada a monitorização ambulatorial da pressão arterial (MAPA) de 24 horas nos 4 momentos. Os dados foram avaliados pelo modelo de efeitos mistos. Resultados: Os dados obtidos no período pré e pós exercícios, mostraram redução em menor valor da variável PAS após a realização do AI e AC comparados ao ER no momento pós exercício (p<0,01). Na FC foi observado aumento no período pós exercício em AI e AC em comparação com ER e de ER em relação ao C (p<0,01). As observações nas 24 horas subsequentes foram obtidas por meio da MAPA, com maior redução da PAS em AI nas 24 horas do que nos outros grupos, sendo a redução da PAS em ER também maior do que em AC e C (p<0,01). Na PAD, a redução em AI e ER foram similares. Considerando apenas o período de vigília, a redução de PAS em AI foi superior aos outros grupos. No período de sono, AI e ER promoveram maiores reduções na PAS, com maior redução da variável PAD em ER (p<0,01). Conclusão: A prática de exercício físico intervalado e resistido promovem maior hipotensão pósexercício (HPE) ao longo das 24 horas subsequentes, em relação ao AC e C. O exercício aeróbio contínuo promove apenas redução da pressão arterial nas primeiras horas após o exercício. / Objective: The present study investigated the acute hemodynamic responses of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR), immediately and within 24 hours after exercise, in hypertensive elderly women submitted to 3 types of physical exercise and control. Methods: Thirty hypertensive elderly women in drug therapy participated of the study. They all underwent to continuous aerobic exercise (CA), interval aerobic (IA), resistance exercise (RE) and control (C), with a minimum interval of 7 days, in random order. All participants were previously submitted to the treadmill stress test, using the ramp protocol due to its better accuracy for the study population. The prescription of the CA and the IA was done by maximum heart rate (MHR) obtained by the test. In the CA intervention, training heart rate (THR) was calculated, with the intensity of 70% MHR, with duration of 40 minutes of exercise. In the IA, we used 80% of the MHR during the conditioning period for 2 minutes and 60% of the MHR during 2 minutes for the recovery period, lasting 40 minutes. The ER was conducted after obtaining a maximal repetition (1RM) in three exercises for the main muscle groups: chest press, leg press and seated paddling, and six more commonly used resistance exercises for the prescription of strength training in the academies, using the number of adequate repetitions through the subjective perception of effort scale (PES). The RE intensity was 50% of 1RM for ten replicates for the specific heating and after 1 minute the load was adjusted to 70% of 1RM, and a range of 6 to 10 replicates were performed for the conditioning. The SBP, DBP and HR values were obtained before and after the exercise sessions by the oscillometric method and after that, 24-hour ambulatory blood pressure monitoring (ABPM) was performed in the 4 moments. The data were evaluated by the mixed effects model. Results: Data obtained in the pre and post exercise period showed a decrease in the SBP variable after IA and CA compared to the RE (p <0.01). In the HR, we observed increase in the post-exercise period in IA and CA compared to RE and RE in relation to C (p <0.01). The observations in the subsequent 24 hours were obtained through ABPM, with a greater fall in SBP in IA in 24 hours than in the other groups, with a decrease in RE also greater than in CA and C (p <0.01). In DBP, IA and RE fall were similar. Considering only the waking period, the SBP decrease in IA was higher than the other groups. In the sleep period, IA and RE promoted fall in SBP, with a greater fall in DBP in RE (p <0.01). Conclusion: The practice of interval aerobic and resistance exercise promoted greater post-exercise hypotension (PEH) during the subsequent 24 hours, compared to CA and C. Continuous aerobic exercise promotes only drop in the first hours after exercise.