This qualitative study used narrative analysis of interviews with 10 older lesbians (aged 55 and over) who have made a financial commitment to live in a continuous care retirement center (CCRC) specializing in lesbian, gay, bisexual and transgender (LGBT) care. The specific aims were to: 1. Describe what has impacted older lesbians' decisions to live in an LGBT-specific CCRC. 2. Describe factors that both positively and negatively impact older lesbians' perceptions of elder care. The study combined two qualitative strategies (across-case, thematic analysis and narrative analysis) and used a convenience sample. Themes identified in across-case analysis were interpreted in the context of patterns in the narrative analysis. Categories, topics and subtopics were organized temporally. This within and across case strategy facilitated the ability to view the whole as well as individual and identify salient themes and representative stories across cases. Stories of past negative experiences with family (resulting from the participants' sexual orientation) as well as past positive experiences within the gay community were widespread across cases. Presently, the participants are caring for older heterosexual family members and realizing that in their lesbian friendship circles they have experienced this type of care and support and not in their biological family relationships. Additionally, they are increasingly aware of their own aging and realizing that at some point they might not be able to support themselves and each other in ways that preserve their dignity and prevent discrimination, as they generally can now. The participants' past experiences (as well as expectations stemming from them) coupled with present experiences and realizations, have led to the decision to live in an LGBT CCRC. They have concluded that the only way to be assured of dignity and respect in elder care is to decide on the LGBT CCRC. Positive perceptions regarding the decision to live in this elder care option were straightforward and directly reflected the findings for Aim I. It is important to understand older lesbians' elder care decision making because continued lack of knowledge may potentially undermine optimal care delivery of elder lesbians across settings.

Among workers from four Southeast Asian countries in Taiwan, Indonesian workers constitute of the biggest group, especially those working in the care service sector. The trend of these workers has been associated with the growing number of the older population in Taiwan. As an Indonesian student studying in Taiwan, I took this opportunity to conduct research on the Indonesian care workers in Taiwan. This study tries to search whether the Indonesian workers are satisfied with their job as caretakers. It includes an overview of their job content, wage, personality job fitness, and supportive work condition. Data was collected by using survey and interviews, with a result of 42 respondents living in Taipei City by using a snowball approach, as well as interviews with an Indonesian representative and Taiwanese government officer. The data collected was analyzed by using cross tabulation and organizational behavior approaches. The study found some relationships between job satisfaction and other variables: i.e.: job contents or characteristics of the caretaking job (such as spends much energy, aggravates health condition, stressful, and restricts social contact with outside of the home), wage (expectation, regularity payment), personality job fit and supportive working condition (no days off and separated room). This study is very comprehensive. The interview results enriched the analyses. It will give much information not only to students, but also to lecturers, researchers and scholars who are interested in the field. It is also a useful resource for the Indonesian and Taiwanese governments to improve working conditions and worker satisfaction. / Among workers from four Southeast Asian countries in Taiwan, Indonesian workers constitute of the biggest group, especially those working in the care service sector. The trend of these workers has been associated with the growing number of the older population in Taiwan. As an Indonesian student studying in Taiwan, I took this opportunity to conduct research on the Indonesian care workers in Taiwan. This study tries to search whether the Indonesian workers are satisfied with their job as caretakers. It includes an overview of their job content, wage, personality job fitness, and supportive work condition. Data was collected by using survey and interviews, with a result of 42 respondents living in Taipei City by using a snowball approach, as well as interviews with an Indonesian representative and Taiwanese government officer. The data collected was analyzed by using cross tabulation and organizational behavior approaches. The study found some relationships between job satisfaction and other variables: i.e.: job contents or characteristics of the caretaking job (such as spends much energy, aggravates health condition, stressful, and restricts social contact with outside of the home), wage (expectation, regularity payment), personality job fit and supportive working condition (no days off and separated room). This study is very comprehensive. The interview results enriched the analyses. It will give much information not only to students, but also to lecturers, researchers and scholars who are interested in the field. It is also a useful resource for the Indonesian and Taiwanese governments to improve working conditions and worker satisfaction.

Thesis (Ph. D.)--Ohio State University, 1982. / Includes vita. Includes bibliographical references (leaves 124-126). Available online via OhioLINK's ETD Center.

This research examined notions of belonging and sense of community through a set of layered lenses that integrated a social model of aging with phenomenology to gain a better understanding of the lived experiences of individuals residing in a long-term care (LTC) home. Conducted in a for-profit LTC home in Ontario, this study analyzed messaging in marketing materials supplied to potential residents and their families in anticipation of a move to a LTC home and in the staff policies and procedures manuals using document and narrative analysis. Themes emerging from this phase were then compared with the first-hand experiences of living in a LTC home as told by residents through the use of a focus group (n=6) and individual interviews (n=6) and experiences of working in a LTC home as described by interviews with staff (n=6). Analysis of marketing documents revealed the theme of let us be your caring community. As messaged in these documents, the LTC home supported residents by caring, embodying the ideals of home through natural living spaces, and supporting meaningful personal connections. This contrasted with messages found in the staff policy manuals. Divided discourses highlighted the tangible complexities of implementing a person-centered philosophy within a business model by describing the industry of care, prescribed customer service, fabricating normalcy and, to a much lesser extent, promoting the practice of person-centered care. Residents’ phenomenological stories illustrated variable un/belonging within a LTC home. Personal experiences of the institutional erosion of belonging, congregate nature of living in a LTC home, changing nature of personal relationships and the prescriptive living environment routinized day-to-day experiences and provided a stark contrast between belonging in community and un/belonging in a LTC home. Weaving belonging into daily tasks described how staff members laboured daily at working to personalize LTC home living, and how they were helpless to prevent losses in community and belonging. After completing the research and analysis of the promotional materials, policy and procedures manuals, and resident and staff transcripts I conducted a broader level analysis of all four sets of themes in order to get a sense of the whole. I concluded there were five tensions of: constructing home from the outside; person-centered care within a biomedical, business model; promoting individuality in a congregate structure; synthetic connections at the expense of long-standing relationships; and fostering living in a death-indifferent culture which justified society’s need to divide and regulate. Incorporating a range of data including promotional materials, policy and procedures manuals, and the voices of both residents and staff, these tensions are not only implicit in the culture of Manor House but within the overarching structure of LTC homes in general and have deep implications on the standing and status bestowed upon older adults in Canadian culture. My intention was to bring to light the contextualized lived experiences of individuals living at Manor House and highlight the structural and social barriers that continue to produce discrimination by “problematizing” aging and subsequently fostering notions of presumably acceptable dividing practices (Foucault, 1982) within society. By examining meanings and experiences of community in a LTC home, and also recognizing the systemic, structural and cultural factors that may shape those experiences, I sought to gain a more comprehensive understanding of the lifeworlds of individuals living within a LTC home.

Despite the benefits of physical activity for older adults, many residents living in long-term care homes (LTC) are relatively inactive. Previous research has revealed barriers to physical activity at the resident-level, organizational, and environmental level. However, little attention has been paid to other factors influencing physical activity within the broader institutional complex. The goal of this study was to uncover how the work of personal support workers (PSWs) related to the promotion of physical activity was socially organized. Institutional Ethnography (IE), developed by Dorothy Smith, guided this study. Smith proposed that peoples’ everyday experiences in local settings are organized, often unknowingly, by the actions of people located outside of the local setting and that this organization is textually-mediated. Two LTC homes in Ontario participated in this study. I began data collection by observing PSWs as they went about their work. Next, I interviewed PSWs and other people located inside (e.g. nurses, managers) and outside the LTC homes (e.g. representatives from the Ministry of Health and Long-Term Care (MOHLTC). Lastly, I collected texts that organized the PSWs’ work, such as Ministry standards. The findings revealed that although the MOHLTC standards were viewed as producing something “good” for the residents, some of the standards disrupted the PSWs’ work, which made it challenging for them to support daily physical activity. The promotion of physical activity was seen as an additional program that happened a few times per week and it was parceled out as a professional activity that was socially organized “out” of the PSW role. The findings suggest that local solutions are needed. A good starting point would be to go and talk to PSWs and residents to determine what type of assignments would permit the incorporation of physical activity into daily care. To embed the promotion of physical activity into daily care, a major rethink and reorganization of PSWs work will be needed, including a greater investment in human and material supports for PSWs.

The purpose of this study is to learn about the professional development practices of physiotherapists working in long-term care homes in Ontario. A survey was created based on relevant literature and piloted for this study. The survey included both quantitative and open-ended questions. 44 Physiotherapist responded, which represents approximately 10% of physiotherapists working in long-term care in Ontario. The results indicate that physiotherapists are isolated from their physiotherapist peers and lack access to communities of practice, professional socialisation, professional culture and social regulation. Although physiotherapists’ interactions with interprofessional teams added breadth to their knowledge, these interactions did not enhance their profession-specific skills. Many physiotherapists are seeking professional community and social supports in healthcare settings outside of the long-term care context. The implications of this study are that physiotherapists, their professional associations, and their college must understand the importance of professional socialization in learning, and ensure that physiotherapists working in long-term care have access to and seek such social support. Physiotherapy service providers in long-term care should provide mentoring, support and opportunities for social learning for their clinicians. Finally, long-term care homes and the Ministry of Health and Long-term care need to ensure that policies provide a better definition of the role of physiotherapists in long-term care.

Ältere und auch pflegebedürftige Menschen werden den Alltag in den Zahnarztpraxen in den kommenden Jahren immer stärker prägen. Mit zunehmender Gebrechlichkeit der Betagten und Hochbetagten sollte sich die zahnmedizinische Behandlung in eine zahnmedizinische Betreuung wandeln. Auch bei einer, im Vergleich zu früher, später eintretenden Pflegebedürftigkeit sind in der Zukunft bei vielen Pflegebedürftigen die zweiten und dritten Zähne zu versorgen. Leider ist festzustellen, dass die zahnmedizinische Versorgung in Pflegeeinrichtungen noch nicht ausreichend standardisiert ist. Von den Pflegebedürftigen in Sachsen, Berlin und Nordrhein Westfalen besaßen nur 18,6 % stationär Pflegebedürftige und 41,2 % ambulant Pflegebedürftige ein zahnmedizinisches Bonusheft. Die Verteilung war regional sehr unterschiedlich. Anteilig besaßen die Pflegebedürftigen in Sachsen am häufigsten ein Bonusheft. Das Vorhandensein des Bonusheftes war weder von Alter oder Geschlecht abhängig. Der Verlust einer besseren Bonusregelung bei Zahnersatzleistungen wird dabei von den Pflegedienstleitungen und dem medizinischen Dienst völlig außer Acht gelassen, teilweise sind die Bonusregelungen auch nicht ausreichend bekannt. Die Organisation eines kontinuierlichen Konsildienstes könnte mit der Anforderung an das Führen eines zahnmedizinischen Bonusheftes verbessert werden. Hierzu müssen aber die Informationen zum Bonusheft gezielt an die Heimleitungen, die Heimaufsichten, die Heimräte, die Angehörigen und an den medizinischen Dienst herangetragen werden.

Graduation date: 1994

There is limited information regarding the provision of rehabilitation services in long-term care (LTC) to meet the needs of residents living with stroke. This project assessed service availability within Ontario-based homes and examined the relationship between service comprehensiveness and functional outcome for residents with rehabilitation potential. The first phase involved survey development and distribution to a sample of homes to assess comprehensiveness. The second phase linked survey findings and administrative data to determine whether comprehensiveness (measured using an index score derived from survey responses) was correlated with change in functional status using linear regression modeling. There was marked variability in service comprehensiveness across responding homes (n=32 of 154 homes; 21%). No significant linear correlation was shown between comprehensiveness and change in ADL function (n=178). Although our study failed to show an association, rehabilitation should be considered an important aspect of LTC programming and should adhere to practice standards where possible.

There is limited information regarding the provision of rehabilitation services in long-term care (LTC) to meet the needs of residents living with stroke. This project assessed service availability within Ontario-based homes and examined the relationship between service comprehensiveness and functional outcome for residents with rehabilitation potential. The first phase involved survey development and distribution to a sample of homes to assess comprehensiveness. The second phase linked survey findings and administrative data to determine whether comprehensiveness (measured using an index score derived from survey responses) was correlated with change in functional status using linear regression modeling. There was marked variability in service comprehensiveness across responding homes (n=32 of 154 homes; 21%). No significant linear correlation was shown between comprehensiveness and change in ADL function (n=178). Although our study failed to show an association, rehabilitation should be considered an important aspect of LTC programming and should adhere to practice standards where possible.