Thesis (M.A.)--City University of Hong Kong, 2008. / "A dissertation undertaken in partial fulfillment of the requirements of the M.A. in Public Policy & Management, City University of Hong Kong." Title from PDF t.p. (viewed on Sept. 24, 2008) Includes bibliographical references (p. 54-60)

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Thesis (Ph.D.)--University of California, Irvine, 2008. / Adviser: Judith K. Treas. Includes bibliographical references.

Thesis (M.A.)--Marshall University, 2003. / Title from document title page. Document formatted into pages; contains ii, 46 p. Includes vita. Includes bibliographical references (p. 43).

This dissertation is the culmination of over two years of fieldwork at a residence for indigent elderly and disabled people situated in the neighborhood of Park Slope in the borough of Brooklyn, New York. The research methodology relied heavily on participant observation, as well as a semi-structured formal interview on a select group of informants, to gain a local perspective on the direct and indirect social effects of institutional policies towards indigent elder populations receiving funding from federal and state level agencies. Using theoretical models from medical and psychological anthropology on cultural studies of death, grieving, and mourning, this analysis focuses on entitlement/benefit policies and their social impact on the organizational structure at a geriatric residential complex. Especially salient were the notions of self-identity and the coping strategies used by the elderly poor and the people who are involved in their care to make do with their low social and economic positioning. At this site, in their everyday routines, older adults faced a myriad of challenges imposed by the lack of clarity and consistent change surrounding implementation of these benefits by various outside institutions. In this diverse setting, social work staff engaged in care-taking practices in the hope of addressing inequalities experienced by the tenant population. Subsequently, social workers became key participants in maintaining the measurements of equality used to determine eligibility for such resources. This was due in part to their gatekeeper status within the privately funded charity-based organization for the diverse sets of residents supported by a mix of private and public entities using federal and state funds. Ultimately, the regulations designed to alleviate inequality created boundaries among tenants and were a source of tension embroiled in larger issues surrounding ethnic, linguistic, and social difference. By exploring the ways in which professional experts with authoritative-knowledge guided and interacted with the elderly-poor at one independent living facility, the research addresses the growing complexity shadowing affordable housing for older adults in the United States as the populace at large continues to diversify. In addressing how these initiatives were enacted and allocated under these conditions, one of the main aims of this research was to reveal how conflicts and struggles emanating from them were managed.

The thesis focuses on the survival mechanisms of the rural poor elderly in Zimbabwe. The situation of the rural elderly is looked at in the context of the ravaging HIV/AIDS pandemic. The focus is specifically directed on the increasing numbers of orphans who are generated following the rampant deaths of their parents (sexually active individuals). With Africa failing to effectively withstand the forcefulness of the pandemic, the community structures in Zimbabwe are being heavily shaken to the detriment of all social groups. It is within this continuum that the research is laid out to investigate the situation on the ground. In this case, a fieldwork exercise was carried out in the Hobodo ward of Mangwe district in Zimbabwe. An intensive and in-depth examination of the critical situation was pursued under the case study model. To make the study more focused, the elderly were placed under investigation with regards to their new role of providing familial care for the orphans. The manner in which they face such a towering task under strained resources and limited knowhow was explored. The well-being of the orphans was also investigated in close relation to the welfare efforts of the elderly guardians. The investigations were made in respect of the contribution of the local resources towards the innovativeness of the elderly guardians. The adaptivity of the elderly and the versatility of the orphans were examined within the confines of the social and the economic capitals of the Hobodo ward. It is within the natural, social and economic capital dimensions of the Hobodo rural locality that the applicability of the sustainable livelihoods framework in explaining the dire social situation of the elderly and the orphans was brought under spotlight. The study was pursued through the qualitative research paradigm. This was done to capture the social perceptions, beliefs and the innovative capabilities of the elderly in their natural environment; and under the fieldwork setting. Several data collection techniques were employed to unveil the subject under study. These included interviews, questionnaires, participant observations, focus group discussions. Sampling was used to produce the research framework. Participants in the research were largely identified through random sampling. In special circumstances, purposive sampling was used. Tape recording and note taking were largely used to capture the responses of the research participants.

This dissertation includes three papers examining financial long-term care planning among low-income aging adults and the consequences of Medicaid policies like estate recovery. Paper one considers Medicaid estate recovery and its impact on Medicaid enrollment and homeownership among low-income adults age 65 and older. Paper two examines the estate planning and wealth transfer behaviors of a cohort of older adults newly enrolled in Medicaid. Finally, paper three presents a case study of Medicaid estate recovery in North Carolina. Collectively, these three papers find that Medicaid policies that target older adults may be having disparate effects depending on socioeconomic status, race, and rurality and exacerbating disparities in intergenerational transfers of wealth while recouping little for state Medicaid programs.

No description available.

Thesis (MSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: In developing countries the increasing number of the aged are often viewed as a problem. In particular, the indigent elderly residing in poor urban areas are at risk of becoming marginalised and underserved. The Western Cape has the third largest elderly population in proportion to the total population in the country. Social assistance in the form of a monthly pension is paid out to all elderly who pass a national means test carried out by South African Social Security Agency (SASSA). An assessment of the characteristics and health status of the elderly collecting old age pensions living in low-income urban poor communities in the City of Cape Town was carried out at pension pay points across four communities, i.e. Gugulethu, Khayelitsha, Mitchells Plain and Bonteheuwel. In community health surveys, choices regarding the methodology have to be made that can have profound effects on the study design and study outcomes. The milieu of the present study is one of urban poverty and specifically those urban elderly who qualify for non-contributory pensions (also called social cash transfers or government grants). The paucity of existing community-based studies on old-age pensioners in the City of Cape Town meant that a cross-sectional survey with wide-ranging coverage of demographic, social and health factors was the most logical design to employ in order to determine the extent of present needs and generate hypotheses for further controlled studies. A systematic random sample of 703 elderly was drawn at nine pension pay-out points in Cape Town Metropole. No pensioners refused to participate in the study. Structured interviews were carried out covering demographics, number of dependents, living conditions, socioeconomic circumstances, health status and needs and utilisation of health services. A reported 43% of participants lived in shacks and 88% reported regularly eating less than 3 meals a day. Eighty-seven percent of respondents reported waiting 3 hours or longer for medication at a clinic while 90% reported being dissatisfied with the service at their clinic. Fifty-eight percent of pensioners reported not being able to see well while 83% did not know where to get their eyes tested. Almost 70% of pensioners said that they have been ill-treated by a family member and 64% scored as severely depressed on the geriatric depression scale. In this study, 266 pensioners solely supported 471 children of which 65 (14%) were disabled children. In 95% of cases the pensioner does not receive any support from the child's parents. The study found that the elderly on a state grant had considerable unmet health needs and required assistance with activities of daily living. The indigent pensioners in this study bore a huge duty of care for minor children as custodial grandparents while not receiving a high level of health support themselves. / AFRIKAANSE OPSOMMING: Die toenemende aantal bejaardes word dikwels in ontwikkelende lande as 'n probleem gesien. In die besonder loop die bejaardes wat in lae-inkomste stedelike gebiede woon die risiko om gemarginaliseer te word en swak dienslewering te ondervind. Die Wes-Kaap het die derde grootste populasie van bejaardes in verhouding tot die totale bevolking in die provinsie. Sosiale bystand in die vorm van 'n maandelikse pensioen word betaal aan alle bejaardes wat die inkomstetoets slaag wat deur die Suid-Afrikaanse Agentskap vir Maatskaplike Sekerheid (SAAMS) uitgevoer word. 'n Ondersoek na die eienskappe en gesondheidstatus van bejaardes wat hulle ouderdomspensioene in lae-inkomste stedelike gemeenskappe in die Stad Kaapstad kom afhaal is uitgevoer. Die studie is gedoen by pensioen-uitbetaalpunte in vier gemeenskappe, naamlik Gugulethu, Khayelitsha, Mitchells Plein and Bonteheuwel. In gemeenskapsgesondheid-opnames moet keuses gemaak word ten opsigte van die metodologie wat diepgaande gevolge vir die studieontwerp en -uitkomste kan inhou. Die milieu van die huidige studie in dié van stedelike armoede en spesifiek die leefruimte van stedelike bejaardes wat kwalifiseer vir nie-bydraende pensioene (ook genoem sosiale kontantoordragte of staatstoelaes). Die gebrek aan bestaande studies van ouderdomspensioenarisse in Kaapstad het beteken dat 'n dwarsdeursnit-opname van die demografie, sosiale en gesondheidsfaktore die mees logiese ontwerp was om uit te voer. Dit is gedoen om die omvang van huidige behoeftes te bepaal en verdere hipoteses te genereer wat deur vergelykende studies ondersoek behoort te word. 'n Stelselmatige ewekansige steekproef van 703 bejaardes is getrek by nege betaalpunte in die Kaapse stadsgebied. Geen proefpersone het geweier om deel te neem nie. Gestruktureerde onderhoude is gevoer wat die volgende aspekte gedek het: demografiese eienskappe, aantal afhanklikes, gesondheidstatus en benutting van gesondheidsdienste. Van die deelnemers het 43% in informele behuising ("shacks") gewoon en 88% het gerapporteer dat hulle gereeld minder as 3 daaglikse maaltye eet. Daar het 87% gerapporteer dat hulle 3 uur of langer gewag het om medikasie by hulle plaaslike kliniek te ontvang terwyl 90% ontevrede was met die diens wat hulle by die kliniek ontvang het. Daar het 58% van die bejaardes gerapporteer dat hulle nie goed kan sien nie terwyl 83% van hulle nie geweet het waar hulle hulle oë kan laat toets nie. Omtrent 70% van bejaardes het gesê dat hulle deur 'n familielid mishandel word en 64% kon as ernstig depressief geklassifiseer word op die geriatriese depressieskaal. In hierdie studie was 266 pensioenarisse die enigste sorg en voog van 471 kinders van wie 65 (14%) gestremd was. In 95% van gevalle het die pensionaris geen geldelike of ander bydraes van die kind(ers) se ouers ontvang nie. Die studie het bevind dat bejaardes wat 'n staatstoelaag ontvang aansienlike onvervulde gesondheidsbehoeftes het en hulp benodig met aktiwiteite van daaglikse bestaan. Die behoeftige pensioenarisse in hierdie studie het 'n groot las gedra aan die versorging van minderjarige kinders as toesighoudende grootouers ("custodial grandparents") terwyl hulleself nie 'n hoë vlak van ondersteuning geniet nie.

貧窮既是一種客觀況，又是一種主觀心感受。既有的研究很少關注老年人自身關於貧窮的經驗，特別是缺乏華人社會背景下貧窮老人主觀經驗的研究。本研究試圖從個體的層面考察貧窮對於中國城市老人多重面向的負面影響，以及他們如何回應這些負面影響，在此基礎上為改善與貧窮老人有關的社會政策提出適切的建議。 / 基於這一研究目的，本研究從批判老年學和抗逆力的理論視角出發，採取建構主義範式和生命故事的研究取向，以中國北京的城市貧窮老人為例，選取17位城市貧窮老人為研究物件，深入研究中國城市貧窮老人的各種壓力，以及抗逆力的內外保護性因素回應這些壓力的機制及其所起到的作用。 / 研究發現，中國城市貧窮老人面臨經濟壓力、疾病與老化的壓力、逆反哺與照顧配偶的壓力，以及貧窮恥感的壓力。貧窮在城市老人的主觀經驗裡意味著多重壓力的相迭，這從主觀經驗的角度揭示了中國城市貧窮老人的多重弱勢。 / 作為抗逆力外在保護性因素的社會支持，它的實現機制因其類型的不同而相異。代際支持對提升抗逆力的作用受到代際團結和代際張力的共同影響；其他非正式支持對提升抗逆力的作用受到互惠關係的影響；社會政策的支持對提升抗逆力的作用受到人情倫理的雙重性和代群差異的影響。這些機制共同決定了貧窮老人的非正式支援日趨弱化，而社會政策和專業服務提供的正式支援有待加強。 / 作為貧窮老人抗逆力的內在保護性因素，工具性策略由獨立性的要求所驅動，意義創造遵循追尋自我價值和重構貧窮經驗這兩條路徑。意義創造在貧窮老人的內在保護性因素中發揮著更為根本性的作用。內外保護性因素的比較有助於我們識別城市貧窮老人中更脆弱的次群體。 / 基於這一研究發現，本研究在原有研究框架的基礎上，補充了貧窮老人的多重壓力和保護性因素的實現機制，擴展了貧窮老人抗逆力研究的研究框架。文章的最後提出了社會政策的具體建議。 / Poverty is both an objective condition and a kind of subjective psychological feeling. However, existing studies pay little attention to older people’s own experience of poverty, especially lacking of studies on subjective experience of the aged poor in the Chinese context. This research attempts to explore from the individual level, the multi-dimensional negative effects of poverty on the aged poor in urban China and how they respond to these impacts. On this basis, appropriate social policies were proposed to improve the living conditions of the aged poor. / Taking the constructivist position and life story approach, this study was conducted from the perspectives of resilience theory and critical gerontology and used the urban aged poor in Beijing, China as an example. Seventeen urban aged poor were selected as the sample for in-depth interview and their multiple stresses, and the mechanisms of internal and external protective factors of resilience in response to their stresses and their functions were investigated. / Research findings show that China’s urban aged poor suffer stresses from economic pressure, diseases and aging, taking care of their spouses, inverse nurturing, and shamefulness of poverty. Poverty means a combination of multiple stresses in the subjective experience of the urban poor elderly. This perspective reveals the multiple disadvantages of the Chinese urban aged poor. / Social support as the external protective factor of resilience, its implementation mechanisms are different by its types. The intergenational support in enhancing the function of resilience is influenced by intergenational solidarity and intergenational tension. Other informal social support in enhancing the function of resilience is affected by reciprocal relationship. Formal support from social policy in enhancing the function of resilience is influenced by the dual nature of interpersonal ethics as well as cohort differentiation. These mechanisms together determine that informal social support of the urban aged poor is gradually weakened. As a result, formal social support coming from social policy and professional social service has to be strengthened. / As one of the internal protective factors of resilience of the aged poor, the instrumental strategies are driven by the demands of independence. The other one of the internal protective factors, the creation of meaningfulness, develops towards two paths, one of which is in search of self-worthiness and the other reconstruction of experience of poverty. The significance of creation of meaningfulness in the internal protective factors of the aged poor exerts a more fundamental function. A combination of the internal and external protective factors can help us differentiate the more disadvantaged sub-group among the urban aged poor. / Based on the findings of the study, the original conceptual framework is reconstructed by supplementing the multiple stresses and the operating mechanisms of protective factors. This has expanded the research framework of studying resilience of the aged poor. Finally, some specific recommendations of social policy are provided. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / 陳岩燕. / Thesis subitted: December 2012. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 456-499) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Chen Yanyan. / Chapter 第一章 --- 緒論 --- p.1 / Chapter 第一節 --- 研究背景 --- p.1 / Chapter 第二節 --- 研究目的與研究意義 --- p.11 / Chapter 第三節 --- 本文的結構 --- p.13 / Chapter 第二章 --- 文獻回顧 --- p.14 / Chapter 第一節 --- 貧窮老人研究的回顧 --- p.14 / Chapter 第二節 --- 與老年貧窮相關的社會政策與研究發現 --- p.49 / Chapter 第三節 --- 與貧窮老人相關的理論解釋 --- p.80 / Chapter 第四節 --- 現有研究的不足 --- p.125 / Chapter 第三章 --- 研究設計 --- p.132 / Chapter 第一節 --- 概念框架 --- p.132 / Chapter 第二節 --- 研究方法 --- p.143 / Chapter 第四章 --- 中国城市貧窮老人的多重壓力 --- p.183 / Chapter 第一節 --- 經濟壓力 --- p.183 / Chapter 第二節 --- 老化和疾病的壓力 --- p.187 / Chapter 第三節 --- 逆反哺和照顧配偶的壓力 --- p.202 / Chapter 第四節 --- 貧窮恥感的壓力 --- p.226 / Chapter 第五節 --- 多重壓力相疊 --- p.237 / Chapter 第五章 --- 貧窮老人與非正式社會支持 --- p.240 / Chapter 第一节 --- 貧窮老人與代際支持 --- p.240 / Chapter 第二節 --- 貧窮老人與擴展家庭的支持 --- p.259 / Chapter 第三節 --- 貧窮老人與鄰里支持 --- p.271 / Chapter 第四節 --- 貧窮老人與其他非正式支持 --- p.291 / Chapter 第六章 --- 貧窮老人與正式社會支持 --- p.297 / Chapter 第一節 --- 貧窮老人與社會政策的支持 --- p.297 / Chapter 第二節 --- 貧窮老人對待社會政策支持的例外個案 --- p.319 / Chapter 第三節 --- 社會政策基層執行者的支持 --- p.325 / Chapter 第四節 --- 其他的正式社會支持 --- p.336 / Chapter 第七章 --- 貧窮老人的工具性策略與意義創造 --- p.347 / Chapter 第一節 --- 貧窮老人的工具性策略 --- p.348 / Chapter 第二節 --- 貧窮老人的意義創造 --- p.372 / Chapter 第八章 --- 討論 --- p.410 / Chapter 第一節 --- 多重壓力：中國城市貧窮老人的多重弱勢 --- p.411 / Chapter 第二節 --- 外在保護性因素：社會支持的再審視 --- p.414 / Chapter 第三節 --- 內在保護性因素 --- p.435 / Chapter 第四節 --- 對貧窮老人抗逆力理論框架的補充 --- p.441 / Chapter 第九章 --- 社會政策的啟示 --- p.445 / Chapter 一、 --- 優勢為本的社會政策 --- p.445 / Chapter 二、 --- 支持家庭的社會政策 --- p.446 / Chapter 三、 --- 雙重權利系統的社會政策 --- p.447 / Chapter 四、 --- 適度普惠的社會政策 --- p.448 / Chapter 第十章 --- 總結 --- p.450 / Chapter 第一節 --- 總結 --- p.450 / Chapter 第二節 --- 本研究的貢獻與局限 --- p.453 / p.456 / 附錄 --- p.500 / Chapter 附錄1： --- 200-2050年中國各年齡段男、女性人口增長趨勢 --- p.500 / Chapter 附錄2： --- 北京市歷年社會保障相關標準（1994-2011） --- p.501 / Chapter 附錄3： --- 受訪者的訪談時間與合計訪談時長 --- p.502 / Chapter 附錄4： --- 2009年11月第一次訪談大綱 --- p.504 / Chapter 附錄5： --- 2010年9月第二次訪談大綱 --- p.507