The purpose of this exploratory study was to operationalize the responses from a sample of the community dwelling older population from Denton County, Texas on disaster preparedness education given by Denton County Health Department (DCHD) personnel. The goals and objectives were drawn from the Texas Public Health and Medical Emergency Management 5-Year Strategic Plan 2012-2016. It was hypothesized that after the disaster preparedness education was received, then comprehension, retention, and application of the information would increase and the goals set forth by the DCHD would be reached. Thirteen sites were used to educate the 224 participants between August 2011 and April 2012. The data were received using a pre-test survey before the training, a post-test immediately after the training, and a follow-up survey call approximately 30 days later. Using Cronbach's alpha, logistic regression and regression analysis through SAS, the data revealed that all DCHD goals were met by this training method and outcome which include the sample population increasing comprehension, retention, and action on the information learned.

This study was a qualitative examination of social, economic, political, and cultural dilemmas that face Peruvian survivors of the Communist Shining Path Revolution, an internal armed conflict that cut a swath of terror and destruction during the years 1980-2000, with a reported loss of 69,000 residents either killed or considered “disappeared.” The conflict affected primarily poor, uneducated Andean campesinos and townspeople in the highland areas of the Ayacucho District. In this study, I looked closely at the responsibilities of both government and NGOs in the facilitation of readjustment during and after times of instability. In addition, specific challenges the elderly, women and campesinos face in a post-conflict world are analyzed and possible social policies are discerned that might be developed to better implement the transition to a new form of community. Ideas that emerged from this research may assist policy shapers in other less developed countries involved in similar conflicts by examining how Peru dealt with its own issues. Methodology included participant observation and interviews with long-term Ayacuchan residents who stayed-in-place during war time, along with migrants who went to live in shantytowns in more urban areas. The government-mandated Truth and Reconciliation Commission report serves as a framework as it …

This secondary research study uses data from two convenience samples of homeless persons in Central Arkansas collected during 2004 and 2011 Point in Time Counts. The prevalence of predictors of homelessness are compared across years, and also compared by age (<50 and > 50) controlling for year of survey. The number of older adults increased significantly between 2004 and 2011 surveys, and reporting serious mental illness and veteran status significantly decreased from 2004 to 2011. Age differences were noted in 2004 with older adults more likely to report serious mental illness in comparison to younger adults. Older adults were also more likely to report veteran status in comparison to younger adults during both the 2004 and 2011 surveys. The predictors of homelessness -- including serious health problems, substance abuse, race, age, and developmental disabilities-- remained fairly consistent from 2004 to 2011 and across "age groups". In addition to Point in Time data, qualitative surveys and interviews of providers were performed for their observations of the older homeless population. Providers indicated their belief that the older homeless population is increasing. Providers suggested possible challenges and reasons for the increase among older adults who are homeless. In central Arkansas, service providers feel …

Dabner, Carol P. Legal Compliance in Guardianship Cases. An Exploratory Study: Investigating Denton County Probate Court Visitors' Program Success with Legal Compliance in Guardianship Cases. Doctor of Philosophy (Applied Gerontology), December 2016, 140 pp., 18 tables, references, 20 titles. Aim: To evaluate the effectiveness of the legal compliance of the Denton County Probate Court Visitor's program in the year 2013. Rationale: Guardianship case management success is based on the presence of legal compliance of both guardians and the Court. When a guardian is legally compliant, a ward is receiving the statutorily minimum standards of care. Legal compliance equates (evidence of) the Ward receiving legally sufficient care. Research has not been vast; it has been consistent as to necessity of guardianship training, monitoring, and narrow focus of research. Evidence based research will assist in defining and developing appropriate court monitoring programs, which can add to the quality of care for elderly and disabled adults. Methods: 1,300 guardianship cases in the probate court. Of these cases, 910 had annual reports of the person filed, which 304 were reviewed using the Legal Compliance Audit. Eight (8) factors of compliance were reviewed with three (3) being Court actions and five (5) being guardian actions. …

The issue of rising number of disasters, the overwhelming increase in number of older adults, and historically flawed evacuations presents real challenges. Disasters can strike anywhere, any time, and have devastating consequences. Since 1900, the number of Americans 65 and older has increased 12 times (from 3.1 million to 36.3 million). During the next two decades, the number of American baby boomers, now aged 45-64, who turn 65, will increase by 40%. As evidenced by recent disasters, the imperfections and vulnerabilities of flawed evacuations for older adults are still present. This study examined the level of willingness to evacuate among older adults in the event of a disaster. Despite the extensive literature on disasters and evacuation, some significant questions regarding evacuation and older adults have not been addressed. This study addressed the following concerns: (1) What is the willingness among older adults to evacuate when asked to do so by emergency management officials? (2) Does the call to evacuate being mandatory versus voluntary influence the willingness of seniors to evacuate? (3) Do preconditions (Gender, Marital Status, Age, Ethnic Origin, and Education Levels) influence the willingness to evacuate among older adults? The sample population consisted of 765 voluntary participants aged 60 …

Understanding underlying mechanisms and pathways that lead to chronic homelessness would help develop intervention strategies that could help prevent subsequent episodes of homelessness. Quantitative data for this cross-sectional study was gathered by interviewing individuals who were homeless in the State of Arkansas, using a structured survey between 2007 and 2011. Qualitative data was gathered using semi-structured interviews between 2016 and 2018. Chi-square statistics and a multivariate logistic regression model was used to analyze the quantitative data, while phenomenological methods were used to analyze the qualitative data. Nearly half of the study participants identified themselves as being chronically homeless. Chronically homeless adults in this region were significantly more likely to be older men with no family ties, more likely to be victims of domestic violence, have higher rates of physical health problems, and have alcohol and substance abuse problems. Results from the multivariate nominal regression revealed that individuals who reported themselves as chronically homeless were more likely to be in the 50 years or older age group. In addition, study findings highlighted a dynamic interplay between three biopsychosocial risk factors for homelessness. Fostering development of inclusive sustainable communities, intergenerational relationships, and shared housing practices could help ease such social inequities and …

A combination of aging and poverty is becoming dominant in African society today, at a time when African countries are expected to be recovering from poverty, and are projected to house the economic growth of the next century. The emergence of aging in African context and the aging of the world population will expose the weakness of the current mechanisms used for older people around the world. As economies grow around the world, the distribution gap between the affluent and the poor widens, and the constant struggles for wealth, power, and social status, amidst scarce resources, continue to be sustained. To remain in charge of economic resources, the powerful few devise means to disenfranchise the weak, and witchcraft accusation is one of such tools used in Northern Ghana today. A new wave of witchcraft accusation has caught the attention of many in Northern Ghana. These victims with certain socioeconomic characteristics appear helpless and without defense against such accusations. As a result, they suffer untold hardships and are often compelled to leave their homes and to reside in camps reserved for witches. This study was undertaken to identify those sociodemographic characteristics, which are commonly shared by witchcraft accusation victims. These sociodemographic …

Although humor is a generally accepted part of everyday life for humans, its existence, importance, and positive influence on older persons are often underestimated. The purposes of this study are to determine whether humor is a normal experience for nursing home residents, enhancing their activities of daily living, and whether it plays a role in contributing to their psychological well-being. The study includes a discussion of research on humor, particularly as it relates to the elderly and the aging process; analysis and comparisons based on interviews with residents on the subject of humor and review of their psychological state as evaluated by the MDS 2.0 nursing facility assessment; individual case studies, and anecdotes illustrating the beneficial contributions humor brings to the lives of nursing home residents.

The effects of teamwork in a long-term care setting were explored, and four key elements of teamwork in the long-term care facility were discovered. These elements--clarity of purpose, clear communication, well-defined decision-making procedures, and participative leadership--are presented in detail. The literature reviewed as well as observations from personal participation in a case study show that employing the teamwork concept in a nursing home environment significantly enhances the quality of life for the residents of such facilities.

The intent of this qualitative, grounded theory study was to understand why the Nigerian (Igbo) adult immigrants in the United States provide long distance international caregiving to their elderly parents left behind in Nigeria, the challenges they encounter, and their views on long-term service care. This study was grounded in semi-structured interviews of 20 Igbo adult immigrants residing in the Dallas/Fort Worth Metropolis. Analysis of the literature demonstrates a lack of existent topic on long distance international caregiving to elderly parents left behind in Nigeria. Findings show that reasons for Igbo adult children immigrants providing care to their elderly parents left behind stem from filial obligation, immigrant’s position in the family, perceived vulnerability of parents, and lack of government support. Also because of cultural expectations, the participants felt obligated to reciprocate to the care their elderly parents gave to them when they were growing up. While providing long distance international care, the participants encountered some challenges like adjusting to their new country, distance, financial constraints, being available for family procreation, issues with means of communication, and legal papers and parental adjustment to life in the U.S. This study also revealed that the participants would support the Nigerian government and private …

The transition from hospital to home or alternate care setting is a time of vulnerability for all patients and particularly for our elders. If not handled appropriately there is a risk to our elders for readmission to the hospital environment that may decrease their overall quality of life and further compromise their health status. in addition to the individual risks associated with patient readmissions, there are societal impacts that reach far beyond our current generation of elders 65 and older. This impact may have dire implications for the future fiscal health of the next generation. a review of the current and past literature shows that there are a limited number of resources available for hospitals to use in order to comply with the new Value Based Purchasing initiatives that are being implemented by CMS regarding the reduction in readmission rates. the problem of hospital readmissions is confounded by the many processes that are available for study, from pre-hospitalization conditions and care through hospitalization, discharge, and finally to post discharge processes. While most research and literature reviews have focused on individual disease causes, there is a need to provide hospitals with a resource that outlines the available options and interventions that …

To meet the growing demand for community-based adult services (CBAS) adult day health care (ADHC) programs, it is important these programs make the necessary modifications in their systems of care to embrace a person-centered care (PCC) model. This study was designed to create an assessment to determine a community-based CBAS/ADHC program's readiness to meet the new federal standards as determined by the program's current operational evidence and by center participants', their families' as well as staff's perspectives. This was measured by self-report of access to the community, choice of setting, individual rights, autonomy and independence, choice of services and supports, center accessibility as well as their needs and preferences in the practice. Results will assist similar CBAS/ADHCs in identifying the necessary modifications within their own program to continue as a certified licensed entity and remain a viable agency.