Thesis (M.S.)--Boston University

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / There is growing evidence of the burden of family care giving, particularly among spouses. but little attention has been paid to the gratifications experienced. A cross-sectional, non-probability, interview study conducted in Massachusetts of 50 wives ages 58 and older supports the hypothesis that caregivers who are more gratified have greater well-being and those who experience greater frustration are more distressed. The caregivers were gratified by having their husbands at home; by believing that caregiving involved reciprocity and nurturing; enjoying moments of warmth. comfort, and pleasure: having gratification from their emotional support systems; and experiencing no change in marital closeness since the illness. Caregivers at risk of mental health problems are those who are highly frustrated and not gratified by the care giving experience. The general frustrations of feeling overwhelmed, resentful, fearful and not resigned were associated with low well-being. Frustration of wives with husbands' ADL ability, with inadequate time for themselves. with constraints of caregiving, with household chore responsibility. and with changes in their emotional support systems also contributed to low well-being. Comparison of the sample with national studies all utilizing the Dupuy WellBeing Scale, shows that the majority of caregivers are in no more distress than the general adult population. Thirty-two percent, however, are in severe distress. Caregiver distress is associated primarily with anxiety, not with depression as widely believed. Distress is not associated with caregiver age or health or with patient illness characteristics, factors that should no longer be used in clinical circles to assess the status of caregivers. Maintaining continuity in preferences and patterns is important to the well-being of caregivers. The study findings can guide the mental health treatment of caregivers particularly as the data lends support to the theory that disruption in the lives of caregivers is a stressor. / 2031-01-01

Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University / OBJECTIVE: The aim of this research study was to see if Nintendo Wii Fit is better able to improve balance in the elderly population when compared to the Matter of Balance program, which is evidence.-based and designed to promote health, balance and wellbeing to decrease the risk of falls. PARTICIPANTS: Residents of an independent living senior housing facility in the Boston area were recruited to participate in this study. A total of 32 residents ages 63 to 90 participated: Wii Fit n=11, Matter of Balance n=11, and Control n=1O. Methods: Participants were separated into three groups. Experimental group 1: The Wii Fit Group performed balance games on the Wii Fit in individual sessions twice a week for three weeks. Experimental group 2: The Matter of Balance Group performed exercises from the Matter of Balance Program in a group setting twice a week for three weeks. The control group received no intervention. Participants in the Wii Fit group had the addition of supplemental home exercises. Two balance and one health and wellness measure were used to determine whether there were any changes following intervention: the Berg Balance Scale, the Tinetti Gait and Balance Assessment, and the Short Form-36 Health Survey (SF-36). RESULTS: Repeated measures ANOV As were used to determine whether there was an effect of the interventions on balance, health and well-being and whether there were any differences between intervention groups. Scores were significantly improved at post-test for both balance assessments: Berg Balance Scale (F1,29= 17.034, p < 0.001); Tinetti Gait and Balance Assessment (F1,29 = 9.715, p < 0.004). The mean increases in balance scores were larger, but not significantly so, for the exercise groups as compared to the control group. Results from the Wii Fit Enjoyment Questionnaire showed that 81% of participants reported high levels of enjoyment while playing the Wii games. DISCUSSION AND CONCLUSION: The Wii Fit is an enjoyable form of exercise as self-reported from an elderly population. Balance improved in the Wii Fit group following intervention, but only a small amount and not significantly more than improvements made by the MOB-exercise and non-exercise control groups. It is likely that the three week duration of the Wii Fit intervention was too short a period to make a large and significant impact on elders' balance.

This dissertation is about how knowledge is constructed in interactions and what knowledge entails in practical social work. It is about how a collective can provide a foundation for the construction and development of knowledge through the interactions contextualized in this study on Swedish elder care, organized by the municipality. This study follows a research tradition that recognizes knowledge as socially constructed, and focuses on the practice of knowledge within an organizational context of care. This is an ethnographic study. The empirical material consists primarily of field notes from participant observations at two elder care units in a midsized city in Sweden. Moreover, the collected materials include national and municipal policy documents, local policy documents and guidelines, and notes from observations in staff meetings and interviews with care workers and managers. This thesis uses Institutional Ethnography as a departure point for analyzing the contextual factors for workers in elder care, mainly women, and the situational factors for acquiring knowledge. The overall aim of this dissertation was to explore knowledge in elder care practice by analyzing the construction and application of knowledge for and by staff in elder care. This sheds light to the Mystery of Knowledge in Elder Care Practice: Locally Enabled and Disabled. In order to pursue this aim, two questions were addressed in the study: 1. How and what kind of knowledge is expressed and made visible in daily elder care practice? 2. How is knowledge shared interactively in the context of elder care? The findings shed light to the situation for care workers in elder care and the conditions for using and gaining knowledge. This situation is problematic as the local conditions both enables and disables knowledge use and sharing of knowledge. Contributing challenging factors are lack of recognition and equal valuing of various forms of knowledge; the organizational cultures and a limiting reflective work to the individual. The main findings in this thesis are presented in three areas: - a way of understanding tacit knowledge, which refers to knowledge gained by care workers through working in elder care; - the connection between an organizational culture and the knowledge shared within the organizational culture; - reflective practice in elder care work and the imbalance between individual and collective reflectivity. These findings have implications for specific knowledge in social work practice and the need for education linked to this knowledge. Formal knowledge alone is insufficient for effective elder care practice; however, informal knowledge is also insufficient alone. Both are needed, and they should be linked to create synergy between the two types of knowledge.

This study explores explanations for Chinese elders’ willingness or lack of willingness to use institutional care. The data is drawn from a survey over intergenerational relationships and age models conducted in Zhenjiang, China, in 2007. Only the responses of interviewees aged 55 and above (310 males and 318 females) were used in this study. Using zero-order correlation and multi-nominal regression analyses, this study examined the factors associated with Chinese elders’ willingness to use institutional care. Study results reveal that Chinese elders’ confidence in availability of familial care was negatively related to their willingness to use institutional care; elders’ knowledge about and impression on elder care homes were positively associated with their willingness. Male interviewees expressed lower levels of willingness compared to female respondents. This study shows that increased knowledge about elder care institution may increase Chinese elders’ willingness to accept institutional elder care.

This qualitative study sought to examine the experience of Asian Americans who provide housing and financial support for first-generation biological Asian parents aged 65 and older. Semi-structured interviews regarding how participants came to take care of their parents, the impact it had on close relationships and participants' plans, the impact of cultural background on taking care of their parents, and the positive aspects of caring for their parents were conducted with eight second-generation adult Asians in the U.S. The data were analyzed using thematic analysis and themes were organized around the areas of inquiry. Participants spoke about fulfilling caregiving responsibilities out of love and obligation; the positive and negative impact of caregiving on relationships with parents, siblings, and significant others; the challenges associated with their own decreased independence and the difficulty of seeing parents age; the benefits of the instrumental support that they received from parents and closer grandparent-grandchild relationships; impact on financial and housing plans; and the expectation of non-financial care from their children. Despite living in an individualistic society, participants appeared to endorse values of filial piety by taking care of their parents. Further, the participants' hopes that their children would continue taking care of elderly family members in non-financial ways in the future suggests that while they maintain the cultural value of filial piety, it is being adapted to the reality of living in an individualistic society. Limitations, clinical implications, and directions for future research are discussed. / Master of Science

In this series of essays about professional burnout, a veteran teacher seeks a way to continue her work and enthusiasm in it, for the sake of both her and her students. To that end, she explores her relationships with her father and mother, and how the practices of teaching and learning she brought from home have affected her present classroom experiences. A complicating factor is the presence of chronic illness and its demands both primary and secondary: her father's Alzheimer's, her mother's bi-polar disorder, and the demands of eldercare for her mother. She also explores her own habitual practice of being a student, in a reflective inquiry into the mind and situation of students from inside her own experiences. Interleaved vignettes of student interaction illustrate the kinds of difficulty that the speaker has with her teaching. They appear chronologically to suggest a developmental movement.

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