Thesis (PhD)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: This study is a pastoral care strategy for the affirmation of the dignity of the poor Black older persons. In this study there is a discussion of how the poor Black older persons suffered the defacement of their dignity under Apartheid and how to a large extent their dignity is still being defaced under the new democratic dispensation in South Africa. These poor Black older persons are victims of various forms of older person abuse. They experience the prejudice of ageism intensely as it is exacerbated by racism; and with no appropriate medical and health strategies in place to provide quality health care; and with inappropriate housing, social services, and residential care services, their dignity is denied. Due to past discriminatory laws and policies these vulnerable older persons suffer the consequences of low levels of formal education within an environment of engineered poverty and racial discrimination which made it impossible for them to enter into quality employment which would enable them to provide adequately for old age. The deprivation thus experienced made it difficult for them to flourish economically and otherwise. At present they are still marginalised and they experience intense forms of loneliness. These poor Black older persons continue to suffer humiliation and indignity in spite of legislation and policies purporting to ensure their well-being. Within a society embracing a neo-liberalist philosophy they are considered unimportant as they do not contribute productively to the economic well-being of the community and are therefore relegated to the lowest ranks of society. With the effacement of their dignity through socially constructed systems their human development is seriously hampered, resulting in a disintegration of human wholeness. The inequality that the poor Black older persons suffer is an indictment against humanity as these older persons have the right to feel at home on the planet. Due to the fact that they are not recognised as having been created in the image and likeness of God, their uniqueness and distinctness as human beings are denied, their identities distorted, and they are not considered worthy citizens. In order to affirm the dignity of the poor Black older persons a practical theological methodology as proposed by Osmer (2008) and consisting of four tasks, has been employed. The notion of a moral economy for the affirmation of the dignity of these poor Black older persons has been utilised. With the moral economy orientation linked with a Liberation Theology methodology the dignity of the poor Black older persons is affirmed as a personal attribute based on the older persons being a category of people being carried into old age by God, enjoying privileged positions of honour and respect, and being eschatological signs and symbols of God’s goodwill towards restored communities in Christ. Within a moral economy the values of reciprocity, responsibility, and interdependence are used to affirm the dignity of these older persons intergenerationally and contextually. / AFRIKAANSE OPSOMMING: Hierdie studie is ʼn pastorale sorg strategie vir die bevestiging van die menswaardigheid van die arm Swart ouer persone. In hierdie studie word daar aangedui hoe die arm Swart ouer persone se menswaardigheid onder Apartheid en in ‘n groot mate in die nuwe demokratiese dispensasie geskend is. Die arm Swart ouer persone het die slagoffers geword van verskeie vorms van misbruik. Die diskriminasie teen ouderdom word intensief deur hulle ervaar soos dit vererger word deur rassisme; en met geen behoorlike mediese en gesondheidstrategieë in plek om in die behoefte van hierdie kwesbare ouer persone te voorsien nie; en met gebrekkige behuising, sosiale dienste en onvoldoende plekke van sorg vir ouer mense, is die menswaardigheid van hierdie ouer mense erg misken. Weens historiese diskriminerende wette en regeringbeleid ly hierdie kwesbare ouer persone die gevolge van lae vlakke van formele opvoeding binne ‘n omgewing waar armoede kunsmatig geskep is en waar rassediskriminasie geheers het. Hierdie omstandighede het dit vir hulle onmoontlik gemaak om kwaliteit werk te kry wat hulle in staat sou stel om toepaslik vir die ouderdom voor te berei. Die ontberinge wat gevolglik gely word, maak hulle ekonomiese en andersydse ontwikkeling onmoontlik. Hulle is gemarginaliseerd en ly aan intense eensaamheid. Hierdie arm Swart ouer persone gaan voort om vernedering en onmenswaardighede te ly ongeag van wetgewing en beleidstukke bedoel vir hul welsyn. Binne die gemeenskap wat ‘n neoliberalisties filosofie aanvaar, word hierdie ouer mense misken omdat hulle nie produktief tot die ekonomiese welvaart van die gemeenskap bydra nie, en daarom word hulle beskou as sonder enige sosiale kapitaal wat hulle dan sosio-ekonomies op die laagste vlak van die gemeenskap sonder enige erkenning van hulle menswaarde en menswaardigheid plaas. Met die skending van hul menswaardigheid deur sosiaal gekonstrueerde sisteme word hul menslike opbloei ernstig gestrem wat lei tot die disintegrasie van menslike heelheid binne die demokratiese bestel van die Republiek van Suid- Afrika. Die ongelykheid wat die arm Swart ouer mense ly is ‘n klag teen die mensdom omdat hierdie ouer mense ontuis voel op die planeet. Hierdie groep is na die beeld van God geskape, maar hulle uniekheid en besondersheid word miskien. Om die menswaardigheid van hierdie arm Swart ouer mense na te gaan, is ’n praktiese teologiese metodologie gebruik soos voorgestel deur Osmer (2008) en word die vier teologiese take soos deur hierdie metodologie voorgestel, gevolg. Betreffende die vierde taak van hierdie metodologie is die konsep van ’n morele ekonomie gebruik vir die bevestiging van die menswaardigheid van die arm Swart ouer persone. Met die skakel van hierdie morele ekonomiese oriёntering met die Bevrydingsteologiese metodologie is die menswaardigheid van die arm Swart ouer persone bevestig as ’n persoonlike eienskap gebaseer of die feit dat hulle ’n kategorie van mense is wat deur God in die ouderdom gedra word, wat dan bevoorregte posisies van eer en respek geniet as eskatologiese tekens en simbole van God se toegeneëntheid teenoor herstelde gemeenskappe in Christus. Binne ’n morele ekonomie word die waardes van wedersydsheid, verantwoordelikheid, en interafhanklikheid gebruik om die menswaardigheid van hierdie ouer mense intergenerasioneel en kontekstueel te bevestig.

published_or_final_version / Social Work / Master / Master of Social Work

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

This thesis investigates the effects of national patterns of migration on informal support for older adults in contemporary Scotland. It argues that geography matters, and develops a multi-scale conceptual framework to analyse the relationships among population mobility, contrasting local contexts in which older people live, and care and support from the intergenerational family and the community. 130 older persons from three locales with different migration patterns are recruited to the study and a mixed-method approach is adopted, using data from the census, a questionnaire survey and a set of in-depth interviews with both older people and formal service providers. The findings demonstrate significant differences between the three study locales in terms of the geography of the intergenerational family and the extent and nature of informal support received. Daughters provide more support than sons, suggesting the continuation of traditional gender norms. Local community is important, especially in the rural locale, but friends and neighbours are not providing a substitute for adult children living at a distance. It appears that non-kin respond to need where physical health is compromised but not where the older person suffers from depression. This raises serious questions about the future of family support in an increasingly mobile society with declining fertility and growing numbers of adult daughters in full-time employment. The relationships demonstrated confirm and extend many previous findings, but the discussion concludes that there are some grounds for optimism. The intergenerational family remains important to its members who can and do overcome geographical separation at times of crisis. Further, slowly changing gender norms, combined with contemporary demographic trends, may effect changes in the pattern of intergenerational support, which will, to some extent, offset the worsening older-age dependency ratios predicted for Scotland and other European countries over the next few decades.

This investigation represents an initial attempt toward the construction of a general life cycle theory of parent-child relations. Emphasis was placed on the parent-adult child relationship with the onset of a filial crisis, e.g., due to illness. After the theory was described, two of the five propositions comprising this orientation (i.e., propositions four and five) were analyzed through a series of twenty-five hypotheses. The objectives of these hypotheses were (a) to analyze the relationship between the length of time involved in various patterns of filial responsibility and the likelihood that these patterns will become institutionalized as obligatory roles and (b) to determine how factors associated with these emergnt role obligations contribute to the cost of caregiving. A probability sample of 180 caregivers was obtained from within the Dallas/Ft. Worth area. Multiple and partial correlation analyses and the use of Student's t revealed that the length of time involved as a caregiver was significantly related to the number of informal caregiving roles performed by adult children. In addition, results indicated that the length of involvement in each caregiving role examined (i.e., household care, transportation service, personal care, medical attention, meal preparation, financial management and mobility assistance) was significantly related to (a) the frequency of providing these services to an aged parent and (b) the level of responsibility in each service area except financial management (which tended to remain constant over time)• An adult child s level of obligation to ensure that caregiving services were provided was also significantly associated with the length of caregiving involvement. Furthermore, this study found tentative support for the contention that the social-psychological cost of providing care for a dependent parent was associated with (a) the frequency of providing transportation services and medical attention, (b) the number of informal caregiving activities performed and (c) the length of caregiver involvement. A set of three control variables (i.e., the household living arrangements and both the aged parent s and adult child's physical health status) were identified as significant contributors to the cost of caregiving. Based on the empirical results of this investigation, propositions four and five of the theoretical perspective presented in this dissertation were supported.

As few studies focus explicitly on social support for residents by residents in retirement communities which have staff, this thesis is designed to explore the nature of informal social support among residents at planned, non-subsidized retirement care facilities: the types, the amount, the impact, the limitation and the appropriateness of such support. Our focus is to explore whether different organization of a retirement community affects social support among residents, so we compare two retirement care facilities. One provides single-level care for its residents and the other provides multiple-level care. We chose our two sites from retirement care facilities in the City of Portland, Oregon. We generated our data by interviewing residents who live independently in the two retirement communities.

"December 2003" / Bibliography: leaves 221-230. / vi, 230 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2004

This project explored the values considered by elderly people, their younger relatives, and health professionals in decisions about residential long - term care, aiming to contribute to the literature on prospectively held values. The mixed methods design utilised a medical record review of 60 frail elderly hospital patients, a stratified survey of 3,015 adults in the South Australian community, and interviews with 36 stakeholders ( 10 elderly people, 10 younger relatives, and 18 health professionals ). The medical record review confirmed that the hospital patients and their outcomes resembled those described internationally. It was used to develop a hypothetical vignette, used in the later studies. Survey responses suggested that when considering a hypothetical long - term care decision, community members put the elderly person ' s physical health and safety first. Situational variables ( the elderly person ' s autonomy, environmental adaptation, and caregiver burden ) appeared secondary, albeit less so with increasing age of the respondent. Thematic analysis of the interviews demonstrated that elderly stakeholders considering a hypothetical decision were more likely to mention autonomy values, and less likely to mention safety values, than were relatives or health professionals. However, elderly stakeholders were also more likely to suggest restrictive solutions, such as residential placement and proxy decision - making. This finding raised methodological issues concerning ' third person ' vignettes, in that respondents might be responding as proxy decision - makers, rather than as if the hypothetical decision applied to themselves. The project confirmed that, in this context, prospectively held values resembled the retrospectively described values identified by McCullough, Wilson, Teasdale, Kolpakchi and Shelly ( 1993 ). Hence, the retrospective literature could be applied. The project supported the importance and complexity of psychosocial predisposing factors when applying the Andersen Behavioral Model ( Andersen, 1995 ) to long - term care decisions. Additionally, the Ecological Theory of Aging ( Nahemow, 2000 ) and the MacArthur Model of Successful Aging ( Andrews, Clark, & Luszcz, 2002 ) were found to be relevant to long - term care decisions for individuals and populations. It was concluded that both clinically, and at a policy level, discussions of long - term care could be more effective if they focussed on maintenance of elderly people ' s autonomy and control, rather than on their physical health and safety. / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2006.

published_or_final_version / Gerontology / Master / Master of Social Sciences

This project explored the values considered by elderly people, their younger relatives, and health professionals in decisions about residential long - term care, aiming to contribute to the literature on prospectively held values. The mixed methods design utilised a medical record review of 60 frail elderly hospital patients, a stratified survey of 3,015 adults in the South Australian community, and interviews with 36 stakeholders ( 10 elderly people, 10 younger relatives, and 18 health professionals ). The medical record review confirmed that the hospital patients and their outcomes resembled those described internationally. It was used to develop a hypothetical vignette, used in the later studies. Survey responses suggested that when considering a hypothetical long - term care decision, community members put the elderly person ' s physical health and safety first. Situational variables ( the elderly person ' s autonomy, environmental adaptation, and caregiver burden ) appeared secondary, albeit less so with increasing age of the respondent. Thematic analysis of the interviews demonstrated that elderly stakeholders considering a hypothetical decision were more likely to mention autonomy values, and less likely to mention safety values, than were relatives or health professionals. However, elderly stakeholders were also more likely to suggest restrictive solutions, such as residential placement and proxy decision - making. This finding raised methodological issues concerning ' third person ' vignettes, in that respondents might be responding as proxy decision - makers, rather than as if the hypothetical decision applied to themselves. The project confirmed that, in this context, prospectively held values resembled the retrospectively described values identified by McCullough, Wilson, Teasdale, Kolpakchi and Shelly ( 1993 ). Hence, the retrospective literature could be applied. The project supported the importance and complexity of psychosocial predisposing factors when applying the Andersen Behavioral Model ( Andersen, 1995 ) to long - term care decisions. Additionally, the Ecological Theory of Aging ( Nahemow, 2000 ) and the MacArthur Model of Successful Aging ( Andrews, Clark, & Luszcz, 2002 ) were found to be relevant to long - term care decisions for individuals and populations. It was concluded that both clinically, and at a policy level, discussions of long - term care could be more effective if they focussed on maintenance of elderly people ' s autonomy and control, rather than on their physical health and safety. / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2006.