Gerontology Commons^™

《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。

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? …

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 …

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? 

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 …

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 …

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 …

Watching Over Cold Waves: The Influence Of Social And Technology Surveillance On Independent Older Adults’ Safety, S M Ashfaqur Rahman

All Graduate Theses, Dissertations, and Other Capstone Projects

Cold waves pose a recurring and serious hazard for independently living older adults, yet the monitoring arrangements that shape their protective responses remain understudied. This study examined how social surveillance, defined as check-ins and support from family, neighbors, and community contacts, and technological surveillance, defined as weather applications, smart devices, and emergency alert platforms, jointly and independently predicted cold-wave safety behavior. A cross-sectional, exploratory mixed-methods design was employed. One hundred independently living adults aged 65 and older, residing in cold-prone U.S. states, completed a survey measuring monitoring frequency, source trust, perceived autonomy, concern across six cold-wave hazard types, and a …

Association Between Caregiver Status And Physical And Mental Health Among National Senior Games Athletes, Chibuzo Uchechukwu Victor Obasi

Graduate Research Theses & Dissertations

As the population ages, more people rely on informal caregivers, which puts many older adults at risk for health problems. Caregiving can be meaningful and strengthen family bonds, but it often leads to more psychological stress, especially for older adults who also have their own health concerns. Research shows that regular physical activity can help older adults build resilience and improve their mental well-being. Still, we know little about the health of older caregivers who stay very active. This study examines the health effects of caregiving among members of the National Senior Games Association (NSGA), a group of highly active …

The Role Of Ombudsman And Social Work Protecting Rights, Roni Alicia Werner

Selected Full-Text Master Theses Collection 2018-

This thesis examines the role of the Ombudsman as an independent and impartial mechanism for addressing complaints, resolving conflicts, and promoting accountability within organizations. It explores how ombudsmen function across institutional contexts—such as higher education, government, and corporate settings—to provide confidential, informal, and accessible pathways for dispute resolution.

The study analyzes key principles guiding Ombudsman practice, including neutrality, independence, confidentiality, and informality, and evaluates their effectiveness in fostering trust and organizational transparency. Through a review of relevant literature and case examples, the thesis highlights how Ombudsman offices contribute to early conflict resolution, reduce formal grievances, and support ethical decision-making.

Additionally, …

Does The Impact Of Volunteering On Health Differ By Wealth? [Research In Brief: Volunteering], Seoyoun Kim, Cal J. Halvorsen

Harvey A. Friedman Center for Aging

Volunteering among older adults has many potential health benefits; however, older adults with more wealth are also more likely to volunteer in the first place, raising the question of whether they are the ones reaping the most benefits. This study asked two questions: (1) Does formal volunteering improve self-reported health and reduce depressive symptoms in older adults? (2) Does the impact of volunteering on these outcomes differ between older adults in the lowest and highest wealth quintiles?

Designing Narrative-Based Ai Assistance For Sensemaking In Collaborative Environments: Case Studies In Education And Dementia Care, Dylan Edward Moore

Dartmouth College Ph.D Dissertations

This thesis addresses a gap in the human-computer interaction literature regarding the design, development, and evaluation of narrative-based AI assistance for collaborative, complex problem solving. I explore this design space through three case studies across the domains of education and dementia care. This work encompasses multi-year industry partnerships and longitudinal fieldwork, user-centered design, dataset curation, model training, and system evaluation.

Specifically, the first case study considers a story-based web platform for teaching AI literacy through peer-generated, personalized narrative scaffolding. Learners on the platform showed significant knowledge gains and other learning-related outcomes. To describe the novel design of this system, I …

Frailty, Home Accessibility, And Falls In Later Life, Bonnie Albright

Graduate Doctoral Dissertations

As more people remain in their homes as they age, the risk of living at home with frailty and reduced function increases, which may also increase the risk for falls in the home. The scientific literature shows that frail people are more likely to experience falls, which leads to many negative outcomes, such as hospitalization, placement in a skilled nursing facility, and even death. The preference to age-in-place (AIP) is more likely to be met if older people live in accessible housing. Accessible homes may mitigate the risk for falls and promote AIP, especially among frail older people.

While there …

Journey Through, Cathan B. Tautfest

Graduate Student Portfolios, Professional Papers, and Capstone Projects

Journey Through is the Master's Portfolio for the University of Montana for Author Cathan Tautfest. This paper serves as the capstone graduation requirement for students of the School of Social Work. Over the final semester of the Master's program, this Portfolio was created, reviewed by committee, and defended before its publication. This Portfolio is a culmination of three years and thousands of hours to demonstrate mastery of the ten Social Work competencies, the elements of Social Work Practice, and critically reflect on time spent in the School of Social Work's Master's of Social Work (MSW) program. This Portfolio reflects on …

The Social Side Of Aging In Place: Community, Belonging, And Cultural Fit, Michael Crespo

University Honors Theses

Aging in place, or the capacity of older adults to remain in their homes and communities as they age has been a central tenet of the field of gerontology and the gerontological social policy area. Although access to physical facilities and service provision has been the main focus of traditional studies, contemporary experience demonstrates that social and cultural issues are equally important as determinants of the quality of life. This thesis discusses the influence of social networks, cultural congruence, and community belonging on the aging in place experience. The content of the study is based on the Ecological Model of …

Assessing Neurocognitive Functioning Among Adults Ageing With And Without Hiv At The Kenyan Coast: Measurement Issues And Correlates, Patrick Nzivo Mwangala, Carophine Nasambu, Ryan Wagner, Mihaela Duta, Gaia Scerif, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Cognitive impairment is one of the most prevalent complications of HIV infection, with significant medical and functional impacts. However, valid, and reliable assessment tools are lacking for the newly emergent ageing population of people living with HIV (PLWH) in many parts of sub-Saharan Africa (SSA), including Kenya. Without these tools, critical intervention opportunities, e.g., psychoeducation, treatment and additional support, are missed. To bridge this gap in Kenya, we adapted the Oxford Cognitive Screen Plus (OCSPlus), a tablet-based cognitive assessment tool designed for low-literacy settings, with adults ageing with HIV ≥ 50 years and their uninfected peers. This study examines …

Assessing Community Needs: Human Services For Adults In Millis And Medway, Caitlin E. Coyle, Michelle Ward, Ceara Somerville

Center for Social and Demographic Research on Aging Publications

This report presents the results of a comprehensive evaluation of issues relating to aging in Millis and Medway. A needs assessment was undertaken in order to support planning on the part of the Towns of Millis and Medway, the Councils on Aging (COAs), and the communities as a whole. Results presented here focus on the characteristics and needs of Millis and Medway residents who are age 60 and older. While the primary goal of this report is to support COA planning, a secondary goal is to present information that will be useful to other Millis and Medway offices and organizations …

Living With Dementia In Kenya: Pathways To Care, Diagnosis And Management, Edna Bosire

Institute for Human Development, East Africa

Background: Sub-Saharan Africa (SSA) is experiencing a sharp rise in the size of theolder population; consequently, the incidence and prevalence of Alzheimer’s DiseaseRelated Dementias (AD/ADRD) is also expected to rise. There is limited research onAD/ADRD lived experiences have been conducted in SSA including Kenya. Our projectaimed to explore patient’s and caregivers lived experiences with Alzheimer’s disease inKenya.

Methods: This ethnographic study was conducted at the Aga Khan University hospital(AKUH), involving in-depth interviews with 21 health care providers, 26 patientswith mild cognitive impairment and 36 caregivers. We also conducted 10 homevisits and observations. Data were transcribed verbatim and thematically analysed.In what …

Community Perspectives On Factors Contributing To Resilience For Healthy Aging In Kenya, Linda Khakali, Everline Onchari, Maureen Ondire, Catherine Onyancha, Chinedu Momoh, Edna Bosire

Brain and Mind Institute

Background: The global elderly population is increasing and expected to double in thenext decade. Aging increases the likelihood of adversities, with resilience becomingan important aspect of healthy aging. Understanding how individuals conceptualizeresilience offers an opportunity to create contextually relevant interventions forpromoting healthy aging. This study aimed to explore adults’ perspectives on factorsinfluencing resilience in Kenya.

Method: Using qualitative methods, 36 adults aged 35 years and above werepurposively recruited from various communities in Nairobi County to participate ininterviews. We asked questions about their understanding of aging, adversity andresiliency. We also provided them with case scenarios of two individuals respondingdifferently to the …

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …

Vitality Tracking In Kenyan Adults Using Wearable Devices And Ecological Momentary Assessments, Karen Blackmon, Benard Alaka, Catherine Onyancha, Litha Musili, Raechel Kamau, Cyprian Mostert, Mansoor Saleh, Zul Merali, Chinedu Momoh, Thomas Thesen

Brain and Mind Institute

Background: Vitality is essential to healthy aging but is elusive to define and measure.Dynamic capture of fluctuations in vitality can uncover abnormal trajectories thatcould be a harbinger of frailty in older adults. Yet, these fluctuations are missed bystatic and/or sparse sampling strategies. To address the need for dynamic and high-density capture of vitality in older adults, we developed a passive sensing and activeprobing digital platform using wearable devices and smartphones. We deployed thisparadigm in older Kenyan adults and evaluated its potential for use in research on thedynamics of accelerated aging.

Method: Cognitively unimpaired (CU) Kenyan adults ≥ 35 years of …

Predicting Accelerated And Delayed Aging In Global Settings: Biobehavioral Age Gaps And The Role Of Global Exposomes, Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilne, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Cyprian Mostert, Chinedu Momoh, Zul Merali

Brain and Mind Institute

Background: Global health challenges like aging and dementia are shaped bysocioeconomic disparities, environmental factors, and social determinants of health.We developed a behavioral age gap (BAG), measuring the difference between expectedbehavioral age and chronological age

Method: We utilized a cross-sectional sample (n = 161,981) comprising countriesfrom Latin America, Europe, Asia, and Africa. Behavioral age was estimated usinga Gradient Boosting Regressor with 10-fold cross-validation, incorporating multiplerisk factors (hypertension, diabetes, heart disease, female sex, visual impairment andhearing impairment) and protective factors (cognition, functional ability, education)associated with healthy aging. BAG was calculated as the difference between predictedand chronological age, and adjusted gaps were derived …

Financial Well-Being Among Self-Employed Older Americans, Cal J. Halvorsen, Byeongju Ryu

Harvey A. Friedman Center for Aging

As people live longer, there has been growing attention in recent years on extending working lives. Although many older adults fully retire, those who continue to work often turn to self-employment—a broad category that includes entrepreneurs, small business owners, consultants, contractors, gig workers, and people who take on side jobs. Rates of self-employment rise sharply with age, with nearly 30 percent of employed adults in their 70s working for themselves—approximately twice the share of those in their 60s.

Preventing, Delaying, And Managing Chronic Disease, Michele Dinman, Logan Fox

Harvey A. Friedman Center for Aging

We are living longer. Today, men and women who reach age 65 will live another 17 to 20 years, on average. As the human body ages, normal biological changes increase vulnerability to illness, and the risk of developing disease increases. At the same time, advances in public health, medicine, and health care have reduced deaths from acute conditions, like infection and accidents, and have increased our chances of living longer into the human life span. Thus, we now have greater chances of developing one or more chronic diseases. Most (75%) adults in the U.S. live with at least one chronic …

Being A Caregiver For A Friend Or Family Member, Nancy Morrow-Howell, Michele Dinman

Harvey A. Friedman Center for Aging

Informal caregivers give assistance to family and friends who have functional limitations that challenge self-care. Most often, caregivers assist younger adults living with a disability and older people with age- associated chronic conditions. Family caregivers are the backbone of our long-term care system in this country, delivering 80% of care. Caregiving is increasing as people live longer with more chronic conditions. Indeed, caregiving is the new norm in our older society. As Roselyn Carter said: "There are only four kinds of people in the world. Those who have been caregivers, those who are currently caregivers, those who will be caregivers, …

Lifelong Civic Engagement, Logan Fox, Emma Ward, Cal J. Halvorsen

Harvey A. Friedman Center for Aging

Civic engagement can be broadly defined as the practice of service (volunteering or informal helping), advocacy, and political participation (voting). Older adults are a large and growing population that frequently engages in these civic activities.

In 2022, the Bureau of Labor Statistics reported that approximately one quarter of the 11 million daily volunteers in the U.S. were age 65 and older. Between 2018 and 2021, there was a 10% increase in volunteer hours filled by individuals over age 65. Research shows this trend will be mutually beneficial, improving the quality of life for older adults who are, in turn, positively …

Climate Change And Population Aging, Anastasia Rhule, Michele Dinman, Natalie Galucia

Harvey A. Friedman Center for Aging

Glaciers are shrinking, river and lake ice is melting earlier, plant and animal habitat ranges are changing, and trees and flowers are blooming earlier. Additionally, longer and more severe heat waves are occurring. Droughts, wildfires, and extreme rainfall are happening at a faster rate than previously predicted by scientists.

Public Views Towards Lifespan, Healthspan, And Healthy Longevity Medicine In Singapore: A Qualitative Study From The Healthy Longevity (Helo) Initiatives, Belinda Wang, Anna Szucs, Elena Sandalova, Zhi Meng Lim, E. J. Horberg, Paul A. O’Keefe, Louis Island, Sonny Rosenthal, Andrea B. Maier

Research Collection College of Integrative Studies

Introduction: Healthy Longevity Medicine (HLM) offers a strategy to reduce the healthspan-lifespan gap, yet public perspectives remain unclear. This study refines the Healthy Longevity (HELO) framework through a qualitative exploration of public views towards lifespan, healthspan, and HLM.Methods: Individuals living in Singapore participated in semi-structured group or individual discussions to explore (a) their understanding of lifespan and healthspan, (b) motivational factors for health behaviours, and (c) their awareness of HLM. Sampling maximised variation across age, sex, and ethnicity. Data obtained through 13 discussions were analysed with a mixed, inductive-deductive approach employing the HELO framework.Results: Thirty-six participants (mean age = 49.4 …