Digital Commons Network^™

《香港多重照顧者面對的挑戰》研究報告, Chak Kwan, Dickson Chan, Meng Soi, Florence Fong, Hiu Wai, Avery Li, Ka Chung, Tom Kwong

APIAS Research Report 研究報告

本研究以質性訪談方式，探討香港「多重照顧者」在日常生活中面對的主要困難及採用的應對策略，並就未來政策及服務提出建議。在本研究中，多重照顧者是指同時需要照顧兩名或以上家庭成員（例如長者、配偶、子女或其他親屬），而其中一名為殘疾或長期病患者。本研究共訪問了45位多重照顧者，結果顯示他們長期承受多方面的壓力，包括時間貧乏、情緒困擾、財政壓力及使用服務困難，影響他們的身心健康、人際關係及職業發展。

就照顧歷程而言，多數受訪者已持續提供照顧，需在工作、家庭與多位照顧對象之間不斷拉鋸，出現「永遠做不完」的感受。在主觀感受上，多重照顧者普遍視照顧為理所當然的責任，但同時感到沉重壓力。他們主要依靠家人分工、嚴密的時間管理、降低對家務與個人生活質素的期望，以及有限度使用社會服務來勉強維持照顧安排。然而，服務分散、申請程序繁複、輪候時間長及資訊不足，使他們難以獲得及時和合適的支援服務。

研究建議有多個方面，包括(1)推行個案經理制度、(2)建立常規化和科學化的照顧者意見收集機制、(3)調整照顧者津貼申請門檻與金額、(4)建立照顧者友善工作環境、(5)優先發展具策略性的「一站式支援」及喘息資源，以及(6)將「多重照顧者」納入長期規劃與制度設計。

High-Frequency Functional Trajectories Predict Depressive Worsening In Singapore's Community-Dwelling Older Adults, Kaung Htet Tun Salai, Yi Wen Tan, Grace Cheong, Paulin T. Straughan

ROSA Journal Articles and Publications

Background/Objectives: Functional difficulty and depression often coexist in older adults, yet local Singapore-based research often lacks detailed temporal resolution due to heterogeneity in ageing. This study employs non-parametric, data-driven longitudinal clustering to analyse functional trajectories and their association with depression, using high-frequency data to pinpoint key intervention periods. Methods: Data were drawn from 4273 community-dwelling older adults from Singapore Life Panel^® (2020–2024). Participants completed quarterly self-reported assessments of ADL, IADL and depressive symptoms (8-item CES-D). We employed k-means longitudinal clustering (kml) to identify functional trajectory groups and Cox regression to evaluate the hazard of increased depression (≥5-point increase in …

Financial Valuation Of Retirement Village Via Stochastic Modelling Of Disability Prevalence Rates, Jackie Li, Mingke Wang, Jia Liu, Jessica Wai Yin Leung

Research Collection School Of Economics

Global mortality rates continue to decline, and life expectancy continues its upward trend. Besides mortality levels, policymakers and providers of financial and health services would also be interested in disability prevalence and its potential future trajectories. The length of time in good health versus the duration with major disabilities or long-term illnesses has significant financial implications for both individuals and society. In this paper, we develop Bayesian common factor models to analyse Australian age- and sex-specific disability prevalence rates. In particular, there are one or more common factors shared by both sexes, as well as specific factors for each sex. …

Knowledge Of Lifespan And Healthspan And Interest In Healthy Longevity Medicine Among The General Population In Singapore: The Singapore Healthy Longevity (Helo) Survey, Jonas John Posko Amalaraj, Belinda Wang, Anna Szucs, Louis Island, Laureen Yi-Ting Wang, Liz J. Horberg, Paul A. O'Keefe, Sonny Rosenthal, Yap-Seng Chong, Johannes J. Meij, Andrea B. Maier

Research Collection College of Integrative Studies

Given the growing global interest in Healthy Longevity Medicine (HLM), the field lacks understanding about public knowledge and interest, which are crucial for any public health intervention relying on HLM. This study presents findings from the Healthy Longevity (HELO) survey conducted in Singapore, assessing public knowledge regarding lifespan (number of years a person is alive), healthspan (number of years a person spends in good health), and interest in HLM. This nationwide cross-sectional survey, conducted between June and August 2024, involved 3034 participants. Main domains including questions on demographics, living arrangements, medical information, health behaviours, income and financial status were tested …

Creating An Identity: Analyzing The Journal Of Western Archives, J. Gordon Daines Iii, Ryan K. Lee, Cory L. Nimer

Journal of Western Archives

The Journal of Western Archives was created as a "manifestation of a Western regional identity for archivists" and to "foster the continuing development of a unique regional identity for archivists working and living in the American West by promoting an improved discourse about archival work and providing another venue for the socialization of new archivists." The journal was founded with the explicit purpose to "provide a venue where archivists working in the West can highlight their unique contributions to the archival profession." The Journal of Western Archives is now fifteen years old and has established itself as an important voice …

A Qualitative Exploration Of Personal Archiving At The Crossroads Of Ai, Aging, And Documentation, Vanessa Reyes

Proceedings from the Document Academy

As we age, our relationship with our personal archive evolves as we experience cognitive shifts. This is even more so if we experience a reality that is shaped by Artificial Intelligence (AI). AI is increasingly managing personal information through automated curation and personalized AI software interactions tailored to users (Hayes & Downie, 2024), sometimes completely unbeknownst to users. Meanwhile, AI-driven automated curation is also helping older adults manage their archives, influencing their ability to maintain agency over their life documentation practices. Older adults use a variety of health-monitoring technologies, such as the Apple Watch, the Samsung Smartwatch, and the Fitbit. …

From Strain To Strength: A Narrative Review Of Wellness Dimensions In Caregiving, Valerie Perkoski

Developmental Disabilities Network Journal

This narrative review investigates the positive aspects of being a family caregiver for individuals with developmental disabilities (DDs) using the National Wellness Institute’s Six Dimensions of Wellness (Emotional, Physical, Intellectual, Occupational, Spiritual, and Social). While much research has traditionally focused on “caregiver burden,” this review highlights the often-overlooked beneficial outcomes of caregiving. Emotional wellness is enhanced through gratitude and resilience. Physical wellness is discussed through interventions like physical activity, which can reduce caregiver distress. Intellectual wellness emphasizes personal growth and self-actualization, helping caregivers find fulfillment in their roles. Occupational wellness shows that employment and community engagement can reduce anxiety among …

Navigating Care And Self-Care: Understanding Latina Caregivers’ Prioritization And Engagement In Self-Care Practices, Denise A. Longoria, John M. Gonzalez, Romeo Escobar, Nelda Rodriguez

School of Social Work Faculty Publications

Introduction: Latina caregivers face significant physical and mental health risks due to the demands of caregiving. The decision to become a caregiver is often influenced by various factors including cultural values such as familismo and marianismo. It is essential that caregivers recognize the importance of self-care to prevent burnout. Without self-care, caregivers face an increased risk of stress, which can negatively affect physical and emotional health.

Methods: A qualitative approach using focus groups to explore Latina caregivers’ understanding and engagement in self-care.

Results: Findings suggested that participants understand the need for self-care; however, family and cultural needs were prioritized. When …

Staff Education To Improving Patient Safety Outcomes Through Structured Staff Education, Imuetinyan Phillipa Ehondor

Walden Dissertations and Doctoral Studies

This staff education doctoral project was implemented to address inconsistent staff knowledge of patient safety principles, disproportionate adherence to safety practices, and underutilization of standardized educational resources in an acute care clinic setting. It was important to address this issue in the context of nursing practice because patient safety is foundational to high-quality health care, directly influencing patient outcomes, regulatory compliance, organizational performance, and workforce morale. The practice-focused question was the following: In an acute care clinic, how does the implementation of a standardized safety protocol education program, compared to existing practices, impact staff knowledge regarding a culture of safety? …

Maternal Work Intensity And Childhood Health: Heterogeneity Over Stages Of Child Development, Kassahun Mamo Geleta

Economics and Management Faculty publications

Over the past six decades, the labor force participation of working mothers in the US has grown significantly. This study is motivated by the growing trend of mothers’ labor force participation and examines the effect of maternal work intensity on child health. It employs the Panel Study of Income Dynamics’ intergenerational survey data and instrumental variable (IV) probit and ordered probit regression techniques. The results show that maternal hours worked has a positive and statistically significant effect on the likelihood of having a healthy childhood, although the estimated magnitude is modest. The fixed effect estimation that accounts for heterogeneity across …

Daily Coping Strategies, Unmet Needs And Daily Health Outcomes Among Family Caregivers Of Persons Living With Alzheimer's Disease And Related Dementias, Henrietta Armah Bennett

ETDs from 2020-2029

Providing care for an individual with Alzheimer’s Disease and Related Dementias (ADRD) is considered the most stressful type of family caregiving that impacts caregivers’ health. More than one in five ADRD family caregivers report their overall health as poor to fair. These adverse health outcomes are often exacerbated when caregivers’ emotional, informational, and practical needs remain unmet throughout the caregiving trajectory. Numerous studies have shown that the ways in which caregivers cope to caregiving-related stressors significantly shape their health outcomes. Despite this evidence, a clear and consistent understanding of caregivers’ own appraisals of their unmet needs, coping strategies and mental …

Older Adults And Suicide: Protective Pathways To Apply Shores In Counseling, Anna A. Ellenson, Jenny L. Cureton

Adultspan Journal

Older adult suicide (OAS) is a growing concern as the U.S. population continues to age and access to counseling expands. Despite legal and ethical requirements, counselors are often underprepared to address suicide in later life, especially through the lens of suicide protective factors (SPFs). This conceptual article introduces SHORES, a research-informed mnemonic (Skills and strategies for coping, Hope, Objections to suicide, Reasons for living/Restriction of means, Engaged care, and Support), to help counselors assess, intervene, and plan treatment with older adults. We review literature on OAS, highlight gaps in counselor training, and provide an application guide for using SHORES with …

Gardening As A Psychosocial Well-Being Activity For Adults: Integrating Eco-Wellness And Developmental Theory, Christopher T. Belser, Helene Tavormina, Ann O'Hanlon

Adultspan Journal

Prior research has demonstrated the myriad of benefits that gardening can offer individuals, ranging from physical, mental, emotional, and social benefits. Though the counseling literature has begun to address the nature-wellness connection via EcoWellness theory (Reese & Myers, 2012), little attention has been paid to the benefits of gardening as a psychosocial well-being activity for adult populations. In this manuscript, authors offer a conceptual framework built on EcoWellness theory, psychosocial development theory, life-span, life-space career theory, and selection, optimization, and compensation theory that contextualizes gardening as a beneficial activity for young adults, middle adults, and older adults. Authors present specific …

Living Well: The Built, Lived, And Social Determinants Of Well-Being, Yi Wen Tan, Zidane Tiew, Emi Loh, Shania Go, Wensi Lim

ROSA Research Briefs

As Singapore transitions into a super-aged society, it becomes imperative for us to develop sustainable, inclusive, and effective models of care. In recent years, there has been growing emphasis on embedding healthcare, social services, and everyday amenities within the community. During this year’s National Day Rally, the Government introduced Age Well Neighbourhoods, a new scheme that builds on existing efforts from the Age Well SG initiative. Age Well Neighbourhoods seeks to expand active ageing centre networks, bring healthcare closer to homes with the establishment of community health posts, and provide greater home personal care services, further cementing its focus on …

Living Between The Lines: Economic Insecurity And Older Americans, Caitlin E. Coyle, Michelle Ward, Nidya Velasco Roldán, Ceara Somerville, Jan Mutchler

Center for Social and Demographic Research on Aging Publications

New estimates from the 2025 Elder Index(TM) suggest that over half of older adults living alone, and about one out of four older couples, lack the financial resources required to pay for basic needs. We compared household incomes for adults age 65 and above living in one- and two-person households to the 2025 Elder Index for each state to calculate Economic Insecurity Rates (EIRs), the percentage of independent adults age 65 or older with annual incomes that do not support economic security. National averages suggest that 53% of older adults living alone and 25% of older couples have annual incomes …

How Do Social Isolation And Loneliness Vary By Age?, Jihye Baek, Cal J. Halvorsen

Harvey A. Friedman Center for Aging

Social isolation and loneliness, which are experienced by many older adults, can negatively impact health and well-being. Although often used interchangeably, social isolation is defined as an objective lack of social ties (e.g., number of close family members or friends) and loneliness as an internal sense of disconnection (e.g., feeling alone even when surrounded by others). Because social relationships, health, and life circumstances change as we age, patterns of social isolation and loneliness may differ by age group. Therefore, this research brief asks, How do patterns of social isolation and loneliness differ across age groups among community-dwelling older adults? 

Happiest People On Earth? A Look Into The Personality Traits Of Disney Adults, Brittannee Mahoney

Doctor of Psychology (PsyD)

The present study examined the personality traits of individuals who identify themselves as “Disney adults” and explored patterns of Disney-related engagement through a newly developed Disney Engagement Scale (DES). Personality traits have a history of being used in many capacities to identify themes within a population. As the Disney adult population grows larger, the opportunity for research increases. In popular media, Disney adults have frequently been shamed for their engagement with the company. The premise of the Disney experience is based on nostalgia, play and cheer. Further, holistic health benefits of nostalgia, playfulness and cheerfulness in adults can be found …

Structural Empowerment And The Work Environment Of Nursing Home Care Workers In China, Yawen Ou

Lingnan Theses (MPhil & PhD)

China is experiencing a profound demographic transformation as its population ages rapidly, driven by declining fertility, increased longevity, and long-term effects of the One- Child policy. Traditional family-based elderly care has become increasingly unsustainable due to the pressures of the “4-2-1” family structure and the rising prevalence of empty-nest households. In this context, there is an increasing trend in institutionalized elderly care, accompanied by a growing demand for Nursing Home Care Workers (NHCWs). In spite of their vital importance, NHCWs often face heavy workloads, poor compensation, low recognition, and limited professional autonomy. This study explores the work environment and structural …

Stressors And Challenges Faced By Mexican American Caregivers Of Family Members With Alzheimer’S Disease, Romeo Escobar, Denise Longoria, John M. Gonzalez, Nelda Rodriguez

School of Social Work Faculty Publications

Mexican American caregivers of individuals with Alzheimer’s Disease face unique stressors and challenges, which may be influenced by cultural, socioeconomic, and systemic factors. This population often assumes caregiving responsibilities based on strong cultural values of familismo which emphasizes family duty and collective care. However, this commitment can lead to increased emotional strain, mental health concerns, financial and physical strain, particularly when caregivers have limited access to healthcare resources, financial support, or respite. Language barriers and a lack of culturally competent healthcare services can further exacerbate stress, making it difficult to navigate the complex healthcare system. The purpose of this study …

Assessing Abuse And Neglect In U.S. Nursing Homes: A Comparative Analysis Across Pre-, During, And Post-Pandemic Periods, Katherine Gane

Theses and Dissertations

Nursing homes are among the most closely regulated providers in the U.S. healthcare system, with both federal and state agencies working together to monitor care and help protect residents. The COVID-19 pandemic, however, introduced unprecedented challenges for facilities and survey agencies alike, disrupting normal operations, limiting in-person visits, and temporarily shifting regulatory priorities. The purpose of this study was to examine how these pandemic-related disruptions were reflected in the severity and reporting patterns of substantiated abuse and neglect deficiencies in U.S. nursing homes. Using publicly available data from the Centers for Medicare & Medicaid Services (CMS), this study analyzed 39,607 …

Nature-Based Approaches To Dementia, Cognitive Impairment, And Caregiver Well-Being: A Scoping Review Of Gardening And Therapeutic Strategies, Mary Dioise Ramos, Marcy Purnell, Jolie Harris, Gloria Giarratano

School of Nursing Faculty Publications

Background: Dementia is a growing global health concern, with behavioral and psychological symptoms (BPSD) contributing significantly to diminished quality of life and caregiver burden. Non-pharmacological interventions, such as gardening and nature-based therapies, are increasingly recognized for their therapeutic potential. Objectives: This scoping review aimed to: (1) map existing evidence on gardening and garden-based interventions for individuals with dementia; (2) assess impacts on caregivers; (3) identify mechanisms of benefit; and (4) summarize effective design and implementation strategies. Methods: Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a comprehensive search was conducted across five databases. Studies were screened using Covidence. Inclusion criteria …

The Impact Of Digital Reverse Mentoring On Older Adults' Digital Literacy: Mediating Roles Of Self-Perceptions Of Aging And Self-Efficacy, Jierong Hu, Minzhi Ye, Haotian Wan, Wengian Leong

School of Social Work Faculty Publications

Background and Objectives: Digital literacy is critical for older adults to maintain social connections, access information, and support overall mental well-being. However, many older adults struggle with using digital devices. Guided by the self-fulfilling prophecy theory, this study investigates how digital reverse mentoring (DRM), referring to younger individuals assisting older adults in learning and using digital technology, is associated with digital literacy, with self-perceptions of aging and self-efficacy as mediators.

Research Design and Methods: A cross-sectional study was conducted with 402 community-dwelling older adults aged 60+ in Macao, China. Control variables include gender, age, education, income, self-rated health, and home …

Fear Of Falling: A Collaborative Approach To Treatment, Alexandra Uhren, Celeste Delap, Kate Jansen

Journal of Interprofessional Practice and Collaboration

Purpose: Physical Therapy (PT) and Behavioral Health (BH) often overlap in patient care; however, collaborative treatment is always not utilized by providers. This case study details the interdisciplinary treatment of a 69-year-old female with a fear of falling; emphasizing the importance of interprofessional collaborative care in treating Fear of Falling (FOF) in individuals at risk for fall-related injury with Cognitive Behavioral Therapy (CBT) and PT interventions.

Problem: FOF is common among older adults and can result in physical, psychological, and social consequences (Lee & Tak, 2023; MacKay et al., 2021). Patients at risk of fall-related injury experience decreased self-confidence in …

Exploring Juvenile Justice System Social Workers’ Dual Role Conflicts, Tayler Janet Deggendorfer

Walden Dissertations and Doctoral Studies

Social workers working within the juvenile justice system face challenges in managing dual roles of providing social support for clients in a punitive environment of incarceration. The problem that was explored in this study is the ethical and practical dilemmas of dual roles for social workers—specifically the potential for burnout and mental health injury for social workers who work within the parameters of both roles. The purpose of this qualitative descriptive phenomenological study was to explore the lived experiences of a selected criterion sample of social workers. The study was framed by Goffman’s role theory. Oral narrative data were collected …

The Effect Of Medical Aid In Dying On Health Outcomes And Risky Behavior Of The Elderly, Jacky Wu

Theses and Dissertations

This study examines the effects of Medical Aid in Dying (MAiD) legalization on health outcomes and behavior among elderly U.S. adults using BRFSS data from 2005-2022. Using staggered difference-in-differences, this paper finds that MAiD increases exercise, lowers BMI, and reduces blood pressure medication use.

Guidelines For Community Engaged Health Research, Carrie Leach, Hayley Thompson, Alex Sass, Patricia Wren, Rodlescia Sneed, Rhonda Dailey, Elizabeth Towner, Maha Albdour, Carla Caringi, Alyssa W. Beavers, Theresa A. Hastert, Vanessa Rorai, Peter A. Lichtenberg, Angulique Outlaw, Ijeoma Nnodim Opara

Institute of Gerontology

Executive Summary:

Wayne State University’s Guidelines for Community Engaged Health Research provide a practical framework for designing, conducting, and evaluating ethical, equitable, and impactful health research that engages community experts in projects that advance health equity in Detroit.

Purpose 

Developed for WSU faculty, staff, and research teams, the guidelines support the meaningful involvement of community experts across all phases of research. They respond to common challenges in community-engaged work, including limited experience with engagement approaches, the need for reflexive and equitable practices, and the time and coordination required for authentic collaboration.

The document defines Community-Engaged Research (CEnR) as collaborative work …

Practical Considerations For Conducting Canine Behavioral Science, Lucrezia Lonardo, Madeline H. Pelgrim, Jeffrey R. Stevens

Jeffrey Stevens Publications

Research on behavior in domestic dogs (Canis familiaris) has increased rapidly recently due to the interest in them as pets, working dogs, and model species for understanding evolution, domestication, and even human health. This interest in canine behavioral science has resulted in the creation of dozens of dog lab worldwide, with more starting every year. Our aim here is to review practical issues that potential dog researchers might consider when deciding how to set up a dog lab and conduct research in canine behavioral science. We hope that this can offer a path forward in promoting high-quality, cutting-edge …

Considerations For School Leadership In Leveraging School-Based Behavior Analysis For Systemic Improvement In Public Education, Virginia Public Schools Behavior Analyst Network, Kira Austin, Elizabeth Boynton, Amanda K. Cash, Meredith Eads, Daniel Irwin, Selena Layden, Daria K. Lorio-Barsten, Emily Muise, Nadine Pittman, Felicia Shelton, Indya Watts-Graves

Human Movement Studies & Special Education Faculty Publications

Public schools face significant challenges, including rising student behavioral needs, chronic absenteeism, and high rates of teacher burnout. These issues are interconnected with and inextricably linked to a need for effective, evidence-based behavioral supports. Educators frequently enter the field lacking the necessary skills and training to manage complex student behavior, often resulting in a reliance on punitive practices that exacerbate problems.

This paper proposes that the expertise of school-based behavior analysts (SBBAs), who are Board Certified Behavior Analysts® (BCBAs®) specializing in education, offers a powerful, underutilized solution. SBBAs are trained in applied behavior analysis (ABA), a data-driven science focused on …

Community Resources For Older Adults With Age-Related Disabilities And Chronic Conditions: A Scoping Review, Oejin Shin, Sojung Park, Soobin Park, Sarah Sunghye Kang, Sunghei Han, Eunsun Kwon, Seoyeon Ahn, Borin Kim

Faculty Publications - Social Work

Community resources are essential for supporting older adults with disabilities and chronic conditions, yet how these resources are conceptualized and evaluated across the empirical literature remains unclear. This scoping review synthesizes U.S.-based research on community resources for older adults with age-related disabilities and chronic conditions, guided by the PAGER framework. Following PRISMA-ScR guidelines, we searched MEDLINE, PsycINFO, CINAHL, and Web of Science, ultimately including 21 peer-reviewed studies. Findings reveal four primary resource domains: healthcare-based services, home- and community-based services (HCBS), behavioral health supports, and environmental or structural resources. Accessibility and utilization emerged as the most consistently examined dimensions, while quality …

End-Of-Life Resources And Place Of Death By Community-Based Housing Type, Sojung Park, Borin Kim, Oejin Shin, Jihye Baek, Byeongju Ryu

Faculty Publications - Social Work

As chronic conditions dominate mortality trends, the place of death has emerged as a key marker of end-of-life (EoL) care quality. Although many older adults wish to die at home, structural barriers often lead to institutional deaths, especially among socioeconomically disadvantaged groups. This study investigates how housing types, defined by economic status, affordability, and congregate features, affect place of death in older adults. Drawing on National Health and Aging Trends Study data (N = 3,145), we examine links between housing type, EoL resource access, unmet needs, and death location. Residents of Subsidized Senior Housing (SSH) report more formal support yet …