Losing a loved one – a child or a spouse –is described as one of the most stressful or negative experience of a person’s life. Aging is associated with a higher risk of the death of close family members, yet few studies have investigated the impact of such losses on different health outcomes either by type of loss or by the combined loss of both a child and a spouse. This thesis is based on three studies examining the effect of bereavement on the health of older adults who have lost a child, spouse, or both and whether the different losses were associated with Life Satisfaction (LS) or mortality. The sample was collected from the Swedish National Study of Aging and Care (SNAC). The results showed that the loss of a child, spouse or both was experienced as among the three most important negative life events in the bereaved groups. About 70% of those bereaved of a child or a spouse mentioned these losses as among their three most important negative life experiences. In the child-and-spouse-bereaved group, 48% mentioned both losses while 40% mentioned only the loss of a child or a spouse, but not both. However, only marginally effects on LS and mortality after child, spouse or child-spouse bereavement in older adults was found. Longer time since the loss was associated with higher LS and lower mortality risk, and type of loss did not seem to determine LS or mortality. Gender differences were found: child-, spouse and child-and-spouse-bereaved men had lower LS than the corresponding groups of bereaved women, and furthermore, child-bereaved men had an increased mortality risk compared to child-bereaved women. Finally, significantly more women in the child-and-spouse-bereaved group compared to the men in this group, mentioned the loss of their child but not the spouse, among the three most important negative life events.

This research is focused on the experiences of older adults participating in an innovative visual arts program at a long-term care facility in Victoria, British Columbia. The program offers participants an opportunity to explore their creativity and identity as artists. Conceptually, the study draws from Tornstam’s gerotranscendance framework (Tornstam, 2005) and the theory of meaning (Frankl, 1963). A narrative inquiry approach was used with data collected through face-to-face interviews and observations of 10 residents and three staff involved in the visual arts program. Findings indicate that the program fostered a sense of community among participants and enhanced their quality of life. The public exhibition of their artwork at a community-based art exhibit validated the merit of their work and gave meaning and purpose to their participation in the program. Findings contribute to a greater understanding of the importance of arts programs that foster creativity in later life and resonate with Tornstam’s (2005) argument that older people living in institutions can experience multiple dimensions of the self through individualized forms of expression. This study concludes by highlighting the need to increase access to arts programs for older people living in residential care. / Graduate / lyciar@yahoo.com

Thesis advisor: Kevin J. Mahoney / Lesbian, gay, bisexual, and transgender (LGBT) older adults in the U.S. face disproportionate risk of increased health and mental health problems as compared to their non-LGBT counterparts. Experiences of harassment, discrimination, and violence due to sexual orientation and gender identity (SOGI) contribute to the chronic stresses associated with being a sexual and/or gender minority. LGBT older adults may avoid or delay needed services in later life, rendering them invisible to health care providers (HCPs) if they do not disclose SOGI and if providers do not ask. This three-paper dissertation explored LGBT older adults' invisibility and outness in aging services. Paper 1 investigated gerontological social workers' biopsychosocial assessment practices to understand how they became aware of clients' SOGI; assessment forms were analyzed and qualitative interviews with social workers were conducted, showing that social workers did not have a systematic way of learning about clients' SOGI. Paper 2 was a quantitative analysis of survey data from 129 LGBT older adults that showed an association between experiences of SOGI-based discrimination/violence after age 50 and not disclosing SOGI to HCPs and having avoided using aging services for fear of coming or being out. Paper 3 was a qualitative analysis of interviews with 22 LGBT older adults that sought to understand how they disclosed SOGI to HCPs. Those who disclosed did so without being asked, because of health conditions, after having sought out an LGBT /LGBT-friendly provider, or after being asked about their sex and/or love lives. Paper 3 findings offered practice and environmental changes that could increase LGBT older adults' SOGI disclosure to HCPs. This dissertation provides suggestions for social work policy, practice, and research aimed at supporting gerontological social workers in learning about their clients' SOGI in an effort to address health disparities among LGBT older adults / Thesis (PhD) — Boston College, 2015. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Thesis advisor: Sara Moorman / This research examines social support transfers, social support networks and psychological well-being among older adults (aged 60+) in five countries in Latin America: Argentina, Brazil, Chile, Mexico and Uruguay. It is based on the following three research questions: 1) How is network structure associated with the receipt of financial and instrumental support among older adults in Latin America?; 2) What motivates the provision of financial or instrumental support to older adults in Latin America?; and 3) Do support transfers from kin and non-kin differently affect psychological well-being among older adults in Latin America? These questions are answered using data from the Survey on Health, Well-Being, and Aging in Latin America and the Caribbean (SABE), which includes information on over 7,000 older adults living in private homes in Buenos Aires (Argentina), Sao Paulo (Brazil), Santiago (Chile), Mexico City (Mexico) or Montevideo (Uruguay). Additionally, the study examines data on over 50,000 members of older adults' household and family networks. Findings confirm the importance of network structure for the receipt of both financial and instrumental support among older adults in Latin America. They also suggest a dynamic perspective of support provision throughout the region, where members of older adult's networks jointly navigate a mix of motivating factors to provide support to older adults in need. Lastly, results highlight the importance of kin support for the psychological well-being of older adults throughout the region. The findings presented in this dissertation provide an important first step in understanding elder support and psychological well-being in Latin America, and offer a strong foundation for future assessments throughout the region. / Thesis (PhD) — Boston College, 2014. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Sociology.

Thesis advisor: Kathleen McInnis-Dittrich / A vast amount of caregiving literature focuses on the well-being of caregivers of older adults, and is primarily focused on the experiences of caregiving women who have traditionally assumed this role. However, the number of male caregivers is growing related to the increase in the number of older adults requiring care, as well as changing sex roles in the family. It is important to examine the impact caregiving has on men to determine the similarities or differences from women in order to inform social work policy and practice. This dissertation begins to answer the question of whether or not there are differences between male and female caregivers through the completion of a secondary data analysis using the Caregiving in the U.S. Study, 2009, conducted by the National Alliance for Caregiving in collaboration with AARP, and funded by the MetLife Foundation. Women are included in the analyses as a comparison group to the male caregivers to identify what similarities or differences exist in the caregiver's well-being. Ordered logistic regression and logistic regression analyses were used to test if caregiver's age and employment status predicted the well-being of caregivers. Moderation analysis was employed to determine what factors moderated the relationship between the predictors and well-being. Seemingly unrelated regression and Chow tests were used to determine if the impact of caregiving on men was unique or the same as female caregivers. Some key findings included that low-income group caregivers reported greater odds of higher financial hardship and physical strain. Caregiving men reported decreased emotional stress, physical strain, and negative impact on social interaction with others since beginning caregiving compared to females. Caregiving men also sought help from unpaid help (e.g., family and friends) more than female caregivers. With several provisions under the Patient and Protection Affordable Care Act of 2010 centered on addressing caregiver needs, it is an appropriate time to consider how to meet the needs of underserved caregivers. Based on the findings in this dissertation, social work policy and practice recommendations are suggested to address specifically low-income and male caregiver needs. / Thesis (PhD) — Boston College, 2013. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Thesis advisor: Susan A. Michalczyk / For my thesis I not only looked at the research that has been done on the topic of homelessness, but I also used my first-hand experience from volunteering at Pine Street Inn, a homeless shelter in Boston's South End. Although I focused more specifically on the older homeless population, I also looked at how society perceives the homeless in general. I realized that the homeless are constantly looked down upon by the more fortunate members of society, and that they are seen as some how deserving of their situation. I came to the conclusion that before we can eradicate homelessness, we, as a society, must change out attitudes and perceptions of the homeless. We must view the homeless as individuals, as human beings. / Thesis (BA) — Boston College, 2006. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: College Honors Program.

Thesis advisor: James E. Lubben / Productive aging is a new and evolving conceptual model that emphasizes the antecedents and consequences of productivity in later life. Proponents of productive aging claim that productive activity in later life is associated with a number of benefits for individuals, communities, and societies, but this assumption has not been widely tested at the country level. In the context of an adapted model of productive aging, the present study identifies the cross-national predictors of and relationship between one form of productivity (viz., labor force participation) and one aspect of well-being (viz., longevity) among older adults. Random effects models with pooled cross-sections and path analysis were used to analyze potential relationships with data from several international data sources. The complete cross-national longitudinal dataset consists of variables measured at five time points or during intervals centered at these time points (i.e., 1980, 1985, 1990, 1995, and 2000) for each of thirty countries that belong to the Organisation for Economic Co-operation and Development. The present study makes one particularly important and new contribution to the cross-national literature on productivity and longevity; the study suggests that work in later life strongly influences life expectancy among older adults, but that some important gender differences should be noted. The present study also suggests that public policy plays a very important role in country level labor force participation rates and life expectancy. More specifically, higher levels of public spending on social issues are associated with lower rates of labor force participation and higher life expectancies. Finally, the present study confirms that the adapted model of productivity provides a solid foundation for cross-national analyses of labor force participation and life expectancy, but highlights the importance of analyzing male and female behavior and outcomes separately. / Thesis (PhD) — Boston College, 2010. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Background: With life expectancies continuing to rise and more people living beyond the age of 65, health services are under increasing pressure to provide effective care for an ageing population. Increased life expectancy increases the risk of long-term conditions like Type 2 Diabetes and cardiovascular disease that require self-management – something that poses a challenge for many people, and for older adults there may be additional barriers. Identifying modifiable factors that impede self-management is an ongoing focus in the literature; and in recent years increasing attention has been paid to the impact of individuals’ attitudes to their own ageing. Aims: The first part of this thesis portfolio is a systematic review of the literature that aims to answer the question “Are lower expectations regarding ageing associated with lower levels of physical activity in older adults?” The second is an empirical study that aims to explore the relationships between attitudes to ageing, executive function, glycaemic control and selfmanagement adherence in older adults with Type 2 Diabetes. Method: A systematic literature search was undertaken to identify studies reporting quantitative analyses of the relationship between expectations regarding ageing and physical activity. Methodological quality of the studies was appraised and synthesized, and clinical and research implications discussed. In the empirical study; 77 older adults completed self-report measures of attitudes to ageing and self-management adherence, and two brief measures of executive function. HbA1c; a biological measure of glycaemic control was also recorded for each participant. Correlations and multiple linear regressions tested the relationships between attitudes to ageing, EF, self-management and glycaemic control. Results: 8 studies (derived from 9 papers) were eligible for the systematic review, and were in consensus in their support of lower expectations regarding ageing being associated with lower levels of physical activity. The findings of the empirical study indicated that more negative attitudes to ageing in relation to physical changes predicted poorer self-management; and more negative attitudes to ageing in relation to psychosocial loss predicted poorer glycaemic control. Conclusion: The current findings are in line with an emerging evidence base supporting a relationship between attitudes to ageing, and physical health outcomes and behaviours; with more negative attitudes and perceptions of old age acting as a barrier to health promoting behaviours. Therefore, interventions targeting those cognitions could help to promote better health outcomes for older populations, as well as promoting healthy ageing and valuing older people – a current focus in policy and strategy.

Age-at-death estimation in older adults is complicated because current techniques fail to capture an older individual’s age-at-death in a narrow enough range. This study aimed to test the relationship between osteoporotic change and age-at-death in the form of intracortical porosity. It was hypothesized that as individuals age, osteoporotic processes increase resulting in a higher percentage of intracortical porosity that may correlate with particular age cohorts. Forty ribs were analyzed, ranging in age from 15 to 84. Ribs sections were digitized using a 40X objective on a Nikon E600 microscope equipped with a motorized stage and a Turboscan montaging system (Objective Imaging Inc., UK). Images were made binary using image ImageJ 2.0. Nine measurements and calculations as described by the Agnew and Stout (2012) method were used: total subperiosteal area, endosteal area, cortical area, percent cortical area (%C/T), porosity area, percent porosity area, absolute cortical area, percent absolute cortical area (%CA/T), and the difference between %C/T and %CA/T. The ranges and mean values for intracortical porosity across the sample were calculated. The effect of intracortical porosity on measures of cortical area were interpreted using a calculation of the difference between %C/T and %CA/T. A Two Sample Independent T-Test was performed to see if there was a significant difference between sexes. Regression analyses were conducted to assess correlations between the traits and age-at-death. No significant difference was found between sexes in regards to intracortical porosity or the difference between %C/T and %CA/T. The mean intracortical porosity was found to be 15.30. The mean value of the difference was found to be 6.95%. Measures of intracortical porosity varied from 0.74% - 31.67% while measures of the effect of intracortical porosity varied from 0.32% - 17.85%. No correlation was found between either trait and age-at-death. There are a number of reasons intracortical porosity might not be correlated with an individual’s age-at-death including (1) processes that influence intracortical porosity, (2) hormonal changes, (3) the current understanding of the relationship between aging and bone cell functions. One should still account for intracortical porosity when conducting histomorphometric analyses, as failure to consider it would result in miscalculations.

This dissertation focuses on the ACCESS Framework which is an open source software framework designed to address four issues with regards to older and novice users with accessibility needs – that they often do not know what support is available within their systems, that they often do not know how to change those settings they know exist, that they often lack the confidence to make the changes they know how to make, and are often unable to physically enable accessibility support.The software discussed in this dissertation serves as a bridge between what users are expected to know and what they actually know by assuming the responsibility for identifying user accessibility requirements and making those changes on the user?s behalf. User interaction with the framework is limited to either expressing approval or disapproval with regards to corrective action. Individual corrections are deployed as plug-ins within this tool.Four studies were conducted during this research. Three of these studies were aimed at evaluating the ACCESS Framework directly with the remaining study being an exploration of a cognitive support tool deployed using the framework. Two of these studies involved participants attempting to perform specific, well-defined tasks on systems that had been configured to the extremes of what was possible with operating system settings. These tasks were attempted with and without the support of the framework. The final study was a focus group in which issues of the framework were discussed by individuals who had been through the experimental trials.The research provided strong evidence that this is an effective mechanism for accessibility configuration when there is a strong match between identified accessibility needs and available operating system support. The system was seen as understandable, useful and appropriate by individuals who had been through the experimental trials. The research provided strong evidence that this is an effective mechanism for accessibility configuration when there is a strong match between identified accessibility needs and available operating system support. The system was seen as understandable, useful and appropriate by participants, with a majority stating that they would be willing to use a similar system on their own machines.