<p> Informal caregiving has been a widely-studied topic recently because many people with chronic and terminal illnesses are being cared for by family and friends in their homes. However, little research has focused on informal caregivers for those with one condition, frontotemporal dementia (FTD). The purpose of this study was to understand how the changed behavior of someone with FTD affects persons caring for those with this type of dementia, with a specific focus on the stress level of informal caregivers. Eleven caregivers participated in this study, with an age range of 42 to 81 years. </p><p> Caregivers whose care recipients are institutionalized reported a higher stress level during time of diagnosis, than that of caregivers who cared for their family member at home. Qualitative responses indicated that a lack of knowledge about FTD can result in a misdiagnosis, leaving caregivers more stressed because the care recipients&rsquo; behavior is left untreated. </p><p>

The number of drivers aged 65 years and older in Canada and the proportion of the population these drivers represent have been increasing for many years and will continue to do so in years to come. This increase in the number of elderly drivers could possibly lead to an increase in the numbers of fatalities, serious injuries and collisions involving drivers of this age group[1]. In order to find ways to reduce the number of collisions involving elderly drivers, and in particular the number of fatalities among the victims of collisions involving drivers aged 65 years and older, the relationship between the characteristics of these collisions and their severity was modeled using both classification trees and logistic regression. In this thesis, we explain the theory behind classification trees and logistic regression before analyzing the data. Both techniques are also compared based on the results of the analysis. In particular, we have validated the classification trees with the more rigorous logistic regression analysis. Consequently, the non-statistician can use the visually appealing trees with confidence.

In the United States, the number of people in the over 65 year category will rise to 80 million, or 20% of the total population by 2040 (Palmore, 2009). This older group traditionally requires more services ranging from healthcare to housing than younger generations. Skilled nursing facilities provide long-term care for older adults who need around the clock nursing support, and are likewise increasing in number to accommodate this change. One of the challenges facing retirement communities is respecting residents' rights of autonomy and control while still following the many required laws and regulations placed on skilled nursing establishments (Frank, 2002). Administrators often desire to create a home-like environment, but the setting may still interfere with residents' ability to make personal choices, which is an essential component associated with empowerment in the home (Frank, 2002). Given the value of stories in revealing hopes, dreams and perceptions, some researchers suggest that narrative inquiry is a valuable technique for gathering data in studies of the elderly. There is an advantage of older adults presenting their views on life: researchers can gain a better grasp of the needs of any individual by accessing his or her personal accounts of the aging experience (Harrigan & Raiser, 1998). This study explored the built environment's role in perceived empowerment by skilled nursing residents. Literature suggests that a sense of control, choice, and autonomy are factors that can determine if an older resident is satisfied with their living conditions that, in turn, may facilitate empowerment and overall well-being. This concept is the foundation for the study's primary research question: What role do empowering elements in the built environment play in supporting quality of life for skilled nursing residents? The Person-Environment (P-E) Fit Theory by Kahana, Lovegreen, Kahana, & Kahana shaped the study's approach (2003), which evaluates the interaction of personal preferences and environmental characteristics along the following four physical and two social domains: Physical Amenities/Aesthetics, Resource Amenities, Safety, Stimulation/Peacefulness, Homogeneity/Heterogeneity, and Interaction/Solitude. As the name suggests, the goal is to have a positive "fit" of the preferences and characteristics that leads to resident satisfaction and psychological well-being (Kahana et al., 2003). The research study was comprised of two phases. The first phase involved interviewing skilled nursing residents which allowed them to share stories with the researcher of their lived experience in their long-term care facilities. They were asked about their perceptions of the spaces in the facilities that the residents determined to be empowering. The second phase took the form of observation mapping in which the researcher tracked the movement and activities of the general population of residents in the common areas of the study's two site facilities. Through the residents' stories and site observations, this study reviewed a range of residents' lived experiences from roommate relations to favorite pastimes to quiet moments. The P-E Fit theory domains proved a helpful model to understand certain physical aspects of empowerment in skilled nursing facilities. However, those domains were not able to fully explain some of the psychosocial concepts that residents expressed, which they perceived to be beneficial. The researcher discovered emerging themes for empowerment that combined both the physical findings as supported by the P-E Fit domains and these additional psychosocial findings that included personal relationships, sense of belonging, sense of identity, and knowledge of community culture. The emerging themes lead to the development of ten guidelines for skilled nursing facilities that identify and recommend empowering elements in the built environment. These included resident room equals home; centralized place to access resources, freedom to access community spaces, centralized social gathering spaces, places for retreat, connection to nature, off-campus adventures, places to explore personal interests, sense of belonging, and safety. The intent is that these guidelines will benefit skilled nursing facility administrators, staff, and other design professionals who seek to empower and improve quality of life for older adults. / A Thesis submitted to the Department of Interior Design in partial fulfillment of the requirements for the degree of Master of Fine Arts. / Summer Semester 2015. / June 29, 2015. / Aging, Built environment, Empowerment, Older adults, Quality of life, Skilled nursing homes / Includes bibliographical references. / Jill Pable, Professor Directing Thesis; Lisa Waxman, Committee Member; Amy Huber, Committee Member.

Adopting the contextual social constructionist perspective on social problems, the present study investigates how older people are portrayed in two public affairs television documentaries in Hong Kong over a period of two decades. There were The Hong Kong Connection (produced by the public service broadcaster, Radio Television Hong Kong); and Chasing Current Affairs (produced by a commercial broadcaster, Asia Television Limited). A mixture of research designs was employed in the analysis, namely: (1) content analysis on the documentary episodes, (2) reviews of government documents and (3) in-depth interviews with social workers and the staff engaged in documentary episode productions. A total of 89 older characters in the 39 surveyed episodes were analyzed. The research questions in the present study include asking: 1) what are the trends and changes in the portrayal of older people in public affairs documentary episodes 2) are there any differences in the portrayal of older people with respect to economic conditions, self-care abilities and the overall personal traits between public service and commercial broadcasters and 3) are there any gender differences in these areas as portrayed in the episodes. The findings of the research indicated that the major themes of the surveyed public affairs documentary episodes are quite “negative”, in particular, episodes produced in the period between 1987 and 1996. However, the depiction of older people in the episodes have generally been improving during the past decade.

Fear of crime among various groups has long been studied in Western societies. Many studies have concluded that older persons tend to exhibit higher levels of fear of crime than other age groups even though they are generally at a lower risk of being victims of crime. However, there have been relatively few studies on fear of crime and associated reasons amongst older persons in Asian cities and Chinese societies. Moreover, most existing studies have generally utilized quantitative methods to examine the possibly causal relationships between fear of crime and its underlying factors, and subjective evaluations by older people themselves of factors related to the fear of crime are very few. This study aimed to investigate factors related to fear of crime by exploring older persons’ perspectives on their living environments and their own situations. A qualitative research design was used to explore how and why fear arises in spite of considerable objective evidence that older persons are at relatively low risk of falling victim of crime. The study employed eight focus group discussions (FGDs) and two individual interviews. To provide a rage of typical HK residential environment, participants were drawn from two main categories of housing (traditional village housing and purpose-built housing) and four different types of physical living environment in Hong Kong (a village, an island, old-town housing, and new towns). Environmental factors, individual factors and moderators of fear of crime have been identified in this study. First, the qualitative findings suggest that environmental factors can be categorized as three dimensions, which include vulnerability (defect of the living environment), defensibility (level of protection that provided by the environment) and supportability (availability of social support that older persons can get when they are at risk). Vulnerability appears to be positive associated with fear of crime, but defensibility and supportability appear to be negatively associated with fear of crime. Second, the findings on individual factors enrich the Vulnerability model proposed by previous researchers, in which physical, psychological and behavioural weakness of older persons can be discussed. Third, moderators of fear of crime (e.g. people who have adjusted to a dangerous place by knowing the latest local crime event or figure.) which concentrate on the cognitive and behavioural adjustment among older persons, have been identified. Finally, policy recommendations for the welfare of older persons in Hong Kong are suggested based on the findings of the research.

INTRODUCTION: In this high technology era, rapid developments in information technology (IT) have the potential to transform the lives of older persons. Ageing tends to be associated with reductions in health status and resources, which can be potentially affect the adoption of new technology. However, the role of IT is becoming ever more influential in our daily living though the digital services such as email, e-banking and e-shopping. Therefore, older persons inevitably come across various IT-related products, especially computers and the Internet, in their everyday lives. Moreover, the quality of life of older persons is important and has been identified as an important aspect of successful ageing. This study will explore the relationships between IT usage and the quality of life amongst older persons in order to determine the main reasons why they do or do not use IT and how they learned about IT. The research findings will contribute to the improvement of understanding of older persons’ well being and attainment of successful ageing, especially in a rapidly ageing society such as Hong Kong. METHODS: The study employed a combination of research methods. A sample of twelve older persons was invited to participate in two focus group discussions (FGD). Nine in-depth interviews with key informants were then conducted with respondents from both professional and older persons’ groups. A face-to face survey was conducted amongst 96 respondents who were recruited from nine neighbourhood elderly centres (NECs) in four districts of Hong Kong. A questionnaire was designed to investigate IT usage behaviour and quality of life among older persons. The questionnaire had four main parts: 1) IT usage and behaviour, 2) Intentions of using IT, 3) IT and quality of life, and 4) Personal profiles of respondents. RESULTS AND DISCUSSION: The results showed that major reasons for IT usage among older persons were perceived usefulness, social trends, maintenance of family connections, self-enhancement and leisure activities. Both professionals and older persons held positive attitudes towards IT usage among older persons, as they mentioned that IT usage is likely to be positively related to older persons’ quality of life. The survey results supported the suggestion that IT usage is indeed related positively significantly to quality of life. The results also suggest that public policies and practices related to IT learning and support and free wireless services should be enhanced to enhance the social connectedness and quality of life amongst older persons.

Demographic ageing of the population is now well established in Hong Kong and, as elsewhere, is raising increasing concerns about the basic needs and the well-being of older persons. Older individuals vary considerably and may try to enhance their well-being in different ways by a range of leisure activities. The gradually improving financial and physical status suggests travel as a potential leisure activity which might enhance individual well-being and quality of life of older persons. Previous research about travel has mainly involved marketing and sociological perspectives. The market research to date for investigating customer values of tourism and typologies of tourists in sociological studies largely ignored the subjective, dynamic, and intangible components of consumption experience. These components, however, are important for understanding travel needs of older persons. The aims of the current study were therefore to identify the characteristics of travel behavior and the main factors that contribute to a pleasurable trip of older persons to investigate travel preferences and travel needs of older persons. The concept of subjective well-being (SWB) which focuses on the positive affect, negative affect, and life satisfaction was found to be useful for understanding the conditions under which travel is desirable to older persons. Two focus groups were conducted to provide insights for the initial design of an in-depth questionnaire survey of 25 older persons age over 60 or above. Inclusion criteria were that respondents would perceive themselves to be able to travel financially and physically before they completed individual face-to-face interviews. By purposive sampling, respondents were selected from urban areas in Hong Kong from sources including social organizations, the researcher’s personal networks, a church, a university, parks, a shopping mall, and public areas in government buildings. After collecting and analyzing the data referring to principles of grounded theory, four patterns of travel behavior and outcome of travel regarding to individual well-being were found. Six aspects of travel preferences and nine factors which contribute to a pleasurable trip were identified. Travel needs of older persons were further investigated and implications for providing travel services for older persons to enhance their well-being were discussed.

With escalating heterogeneity of the older population due to extending healthy life expectancy, chronological age is decreasingly likely to be an appropriate discriminator of social groups among the diverse population. It may be more fruitful to understand how older people actually feel and live their lives than merely using chronological age as a categorizing variable. Therefore, the present research investigates individual age identity which may provide a more realistic indicator of ageing in the life course. It may also underpin many behavioral phenomena. Age identity focuses on how an individual perceives himself or herself in terms of age. Previous studies have shown mixed findings between age identity and a number of variables, such as chronological age, gender, socio-economic status and health status. However, relatively few studies have gone beyond the determinants of age identity to explore the question of how age identity affects the adjustment process in later life. Self-perception is often cited as one of the components of both physical and psychological well-being, so it is also important from this perspective. It seems a good adjustment can contribute to a successful later life, and the study of age identity, as a specific dimension of self-perception, its determinants as well as consequences, may be crucial in such adjustment. Thus, age identity and adjustment form a timely research agenda and they grow to be vital topics for policy and service delivery. To study the relationship between age identity and the adjustment process, in other words, how people feel about themselves and whether they consider themselves to be old, face-to-face in-depth case interviews were conducted with 12 retired secondary school teachers and 10 retired manual workers. Results from this qualitative study show that different people hold different age identity irrespective of chronological age. Retired secondary school teachers in general reported younger age identity than the retired manual workers, mainly due to their previous job nature, more flexible retirement and greater work continuity after retirement. Three different patterns of adjustment were identified: assimilation, accommodation and mixed. Those with a younger age identity tend to take up assimilation while those with an older age identity were more likely to assume accommodation. It was also found that previous life experience, significant others and individuals perceptions of age and retirement are important in affecting age identity and adjustment patterns. In addition to its contribution to gerontology, this study of age identity and adjustment pattern in later life among different occupational groups can help policy-makers understanding of the needs of older persons. Knowledge of different age identification and adjustment patterns can help guide them on how to assist the diverse and expanding older population in maintaining a meaningful later life. Policy makers can thus give individual care and make personally suited interventions, with reference to one’s condition, or at least that of a particular segment of the older population, rather than their chronological age. It is also hoped that the current research will contribute in terms of guiding policy-makers on adjustment strategies design for the expanding older population. It may shed light on preventive measures by encouraging individuals to activate their own resources rather than depending on public social and health policies, many of which focus on needier older persons.

The thesis looks at volunteering, an activity in which time is freely given as a gift to benefit other people, groups and society. Formal volunteering, as opposed to informal helping, entails stronger commitment via organisations that offer more or less organised assistance often on an individual basis. The thesis suggests that older retired persons provide an invaluable pool of formal voluntary workers amidst the growing need for social services and fewer resources for social welfare expenditure. This pool will grow even more in the future. Moreover, the research looks at the experiences of social engagement in older and associations between volunteering and psychological well-being (PWB) of older persons, including improved self-esteem and life satisfaction. This is novel research on this aspect of volunteering in Chinese societies. The research was informed by activity theory, role theory and the concepts of successful ageing and productive ageing. It was essentially as qualitative study with the aims of identifying motivations for volunteering, the role(s) of volunteering, related effects on PWB of older persons, and perceptions of benefits and impacts of volunteering on older persons’ PWB. PWB was measured on two foci, subjective well-being (life satisfaction, self-esteem, positive/negative affects) and objective well-being, including depression, anxiety, social impairment and hypochondriasis, the four identifiable elements of distress covered in the General Health Questionnaire (GHQ-12). Data were gathered from two groups of 60-to-75-year-old retired respondents, volunteers (n=56) and non-volunteers (n=21), through the use of triangulation (focus group interviews, in-depth case interviews and questionnaire). The responses were processed using mainly qualitative data and descriptive analysis, followed by a comparison of GHQ-12 score difference between volunteers and nonvolunteers. The thesis has sufficient data, novelty and academic merit. It also has some very useful findings, showing that volunteering in old age can be inspired by selfmotivation, can be encouraged by others and can be seen as a way to show gratitude to society. Volunteers were found to have significantly higher level of self-rated health, life satisfaction, self-image and PWB. Volunteering seems to alleviate volunteers’ negative emotions. Interestingly, although older volunteers perceive volunteering mainly as a leisure activity, they are aware of some type of optimal level of social participation, implying that adverse effects of excess participation in volunteering on PWB may be being recognized among older persons. The thesis should provide ample material for publications in the refereed journals.

Residential relocation could potentially be injurious to older persons. Indeed, much of the research literature in Western societies points out that involuntary residential relocation may exert undesirable impacts on older persons’ lives. Those impacts could be even greater if the relocation was forced upon the individual one person. Therefore, the purpose of this research is to investigate the impacts of involuntary residential relocation on older persons’ quality of life, stress and coping in Hong Kong. From a review of the literature, it was hypothesized that there will be perceived stress during and after the process of residential relocation, and satisfaction with relocation arrangement and quality of elderly life are related. This research method adopted was a one-shot group pretest-posttest experimental design with a panel study, having the dual purposes of explanation and description. Structured and semi-structured questionnaires were used to collect quantitative data and qualitative data in order to test the hypotheses, and provide subsequent policy information for the service and care providers. A total of 85 and 74 older persons were interviewed in the pretest (male=19 and female=66) and the posttest (male=15 and female=59) respectively. They were recruited from two public housing estates: Valley Road Estate and Ho Man Tin Estate, and almost all of them were finally relocated to Ho Man Tin South, effectively a relatively short-distance intra-urban relocation. Most of the hypotheses of the study could be supported. The findings indicate that the respondents perceived stress from the relocation and associated financial strains from the costs. The greatest stress they faced was the processes before the actual move. Moreover, the results also revealed that their quality of life, both in the pretest and posttest studies, was statistically and significantly correlated to their stress, coping strategies and satisfaction with the existing housing. In addition, more than half of the respondents expressed the view that the non-government organizations gave them the greatest help or assistance in this stressful life event. Nonetheless, the respondents showed that they experienced higher levels of stress and lower satisfaction with new estate after the move in spite of the objectivity better living conditions. They also indicated that they had a lower quality of life and poorer coping strategies after the move. Thus, it appears that residential relocation is not generally favorable for successful ageing. Furthermore, the female respondents and older persons who lived alone reported that they experienced more problems in the move than other respondents. The older residents from Valley Road Estate had greater satisfaction with the new housing than those from Ho Man Tin Estate perhaps because their residential environmental improvement were greater, offsetting some stresses of the move. Last but not least, some constructive suggestions were offered to all players, including the Housing Authority, the NGOs, the older persons and their families.