Keeping the beat: use of rhythmic music during exercise activities for the elderly with dementia

Involving people with dementia in group exercise activities often presents a challenge. The effects of a recorded instrumental musical accompaniment was evaluated on participation in a series of 14 exercise activities with a group of nursing home residents with dementia. All exercise sessions, specifically designed by physical therapists for older adults, were lead by an activity aide and consisted of a series of seated exercises. Direct observations of resident behavior were conducted over a 25-week period in a reversal experimental design. Results showed increased levels of participation during the experimental condition observations where rhythmic music accompanied the exercise activities. The music intervention was most successful on those generally most willing to participate in social activities.

Eddies in the stream: the prevalence of uncertain plans for retirement

OBJECTIVE

This study examined an assumption of retirement theory that typifies older workers as preretirees who are planfully engaged in paths toward retirement.

METHODS

Using survey responses among workers in the 1992 and 1994 waves of the Health and Retirement Study, we described the prevalence of nonsubstantive answers to questions about the expected form and timing of retirement (e.g., "don't know," "haven't thought about it"). We tested explanations for this uncertainty as an artifact of the survey process, but also as an outcome of the opportunity structure for retirement planning.

RESULTS

Survey procedure did generate some of these noncommittal responses. Depending on question type, approximately 10% to 40% of workers did not state when or how they would retire, and such responses were less prevalent across age and time. In addition, categorical uncertainty about form and timing was theoretically predictable in a framework that supposed that workers less subject to a socially attended life--at work or away--would be more undecided about the future.

DISCUSSION

Uncertainty is an authentic, meaningful stance toward retirement that theory and research design should not ignore. Just as actual transitions to retirement can be ambiguous or blurred, the expectation of retirement, as well, can be untidy.

The role of job-related rewards in retirement planning

The authors used data from the first wave of the Health and Retirement Study ( F. Juster and R. Suzman 1995) to evaluate whether certain job-related gratifications might reduce retirement planning. Three definitions of retirement planning were evaluated and then regressed separately on a set of variables that included 3 types of job-related satisfactions (intrinsic gratification, positive social relations, and ascendance in the workplace) and 7 covariates: education, age, sex, health, marital status, race, and pension eligibility. Findings indicated that jobs high in ascendance were related to an increase in certain types of retirement planning, but jobs high in intrinsic rewards and positive social relations were related to less planning, regardless of how planning was defined. The findings suggest that information about work-related rewards may be useful in targeting individuals who might benefit from retirement planning programs, in developing planning programs to help workers realize more complex retirement plans, and in assisting employers who hope to retain older workers.

Profiling plans for retirement

Actual decision making for retirement is largely inaccessible to investigation, yet research can focus on plans as a window into the preretirement process. This article proposes a construct that profiles five generic types of retirement plans, including plans to retire completely, change jobs, never retire, and uncertainty about retirement. The heuristic value of the construct lies in its recognition of the heterogeneity of retirement intentions. The five plan types were operationalized among workers aged 51-61 in the 1992 Health and Retirement Study. Convergent validity was demonstrated by comparisons to analogous survey questions. Construct validity was shown by predictable relationships between intentions and elements of workers' opportunity structure. The retirement-plans construct can serve as the foundation for a taxonomy of specific retirement plans (e.g., about timing, employment), to organize research on stability and change in retirement intentions, and characterize the path dependence of eventual retirement behavior.

The impact of respite use on nursing home placement

The results of experimental studies of the effects of respite care have been difficult to interpret because researchers have lacked experimental control over who actually received the treatment. Data from one such study are reanalyzed, focusing on the linear relationship between amount of respite use and probability of nursing home placement at the end of the treatment period. The results indicate a significant negative relationship between amount of respite use and nursing home placement.

A longitudinal analysis of nursing home placement for dependent elders cared for by spouses vs adult children

Five-wave panel data from 531 informal caregivers and frail elders were analyzed using an event history framework to identify how changes in the caregiving situation are related to nursing home placement. The results indicate that the predictors of placement differ substantially for elders cared for by spouses vs those cared for by adult children. In addition, the findings suggest dramatically different descriptions of the caregiving role over time for the two groups of caregivers. There were differences not only in the conditions under which caregiving ends, but also apparent differences in when caregiving begins and how it is perceived by the caregiver. Differences in the probability of placement of elders cared for by spouses vs adult children are interpreted within the framework of these contextual differences in the caregiving role.

Investigating patterns of service use by families providing care for dependent elders

The behavioral model developed by Andersen in 1968 was used to investigate patterns of support service use by families caring for dependent elders. It was hypothesized that differences in background or predisposing factors that serve to define caregivers (e.g., spouse vs. adult-child) would interact with need factors to influence the use of "discretionary" support services (e.g., adult day care), but not influence the use of "nondiscretionary" services (e.g., hospitalization). Information was obtained on the use of eight different support services from a sample of 503 caregiving dyads. Caregivers were either spouses or adult children of the dependent elder. The results supported the hypotheses derived from the behavioral model and indicate that, among caregiving families, it is important to consider not only the type of service, but who is assessing the need for that service.

Caregiver burden and generic well-being: opposite sides of the same coin?

Caregiver burden is one of the most commonly used variables in caregiving research, both as a predictor and as an outcome. It has been suggested that caregiver burden can be measured in terms of discrete dimensions of well-being and that burden and well-being represent opposite sides of the same coin. The goal of this study was to explore this issue further by comparing commonly used dimensions of burden with parallel dimensions of well-being, both as outcome variables and as predictors of other outcomes, in a sample of caregivers. The findings suggest that burden may tap a unique domain of caregiving outcomes that is not represented by more objective indicators of these effects. Dismissing burden as an unnecessary or redundant construct seems premature.

Foster care for older adults: issues and evaluations

"Adult foster care" is a label that has been applied to very diverse programs. Although adult foster care appears to be a potentially important element in the continuum of care for older adults, its assumptions and characteristic features have not been clearly explicated. In this paper, common assumptions underlying adult foster care are suggested, representative adult foster care programs are examined, and persisting issues discussed. The results suggest that, as yet, there is no consensus among practitioners as to what are reasonable goals for adult foster care, who should participate in such programs, and what constitutes evidence of program success. Until these issues are resolved, adult foster care is likely to remain an underutilized form of long term care for older adults.

Determinants of VA utilization. The 1983 survey of aging veterans

By the end of the decade, fully one half of American males aged 65 years and over will be veterans. In anticipation of the increased demand for medical services, the Veterans Administration recently commissioned a survey of the needs of aging veterans. From a national probability sample, approximately 34,500 households were screened to yield interviews with 3,013 veterans aged 55 years and over. Using multivariate regression analyses, the present study employed this data set for two purposes: 1) to identify covariates of past and present service utilization in the VA system, and 2) to identify the conditions under which veterans will declare an intention to use VA services in the future. Independent variables included medical diagnoses, ADLs, demographic and background characteristics, convenience and proximity to VA facilities, alternative forms of insurance coverage, VA eligibility, and attitudes about the quality of VA care. The results suggest markedly different predictors for current use versus likelihood of future use; however, income was related to both current and intended future utilization. The implications of these findings for policy development and utilization projections are discussed.

Isolating age, period, and cohort effects in developmental research. A critical review

Separating age, period, and cohort effects in developmental research is complicated by their linear dependence. Differing approaches have been advanced to address this problem. These approaches generally presume that age, period, and cohort are conceptually discrete entities; that is, they are confounded statistically, but not logically. This article outlines the dilemma, reviews solutions that have been advanced, and critically examines the assumptions on which these solutions are based.