[Subjective time left in life and precautionary relocation planning in the last half of life]. / Subjektive Restlebenszeit und vorsorgende Umzugsplanung in der zweiten Lebenshälfte.

BACKGROUND: Many people wish to remain in current residence for as long as possible. Nonetheless, they do think about their residential future. For older people the question of where to live must be considered with respect to age-related changes and continuity. So far only little research has been focused on the influence of the subjective perception of remaining lifetime until death on plans for the future, for example regarding relocation. OBJECTIVE: This study investigated the influence of the subjective perception of time left to live on relocation planning and its timing in the further course of life. MATERIAL AND METHODS: The data were obtained from a paper-pencil questionnaire including 2156 persons aged 50 years and older (average age 65.5 years, SD = 9.7 years, range 50-94 years, 51.1 % female) who were asked about their wishes and plans for the future, particularly about their relocation considerations and the subjective perception of remaining time until death. RESULTS: Approximately 39 % of the subjects considered relocation in the further course of life. Besides social demographics, current housing and the state of health, the subjective time left in life had a significant influence on the consideration of relocation and its timing in the further course of life. Persons who perceived their time horizon as limited considered relocation later in life (temporizing relocation planning) than persons who perceived themselves to have more time left in life. Their temporal occurrence of precautionary relocation planning is embedded earlier in the course of life. CONCLUSION: Thoughts about the residential future of older people should be considered not only in connection with the content of these wishes but also related to the future time perspective and the timing in the further course of life. This can be of assistance in consultation and decision-making situations.

[Care preferences and spatial mobility : Factors influencing care-related willingness to move of elderly people in partnerships in a rural area]. / Pflegepräferenzen und regionale Mobilität : Einflussfaktoren auf die pflegebezogene Umzugsneigung älterer Menschen in Partnerschaften im ländlichen Raum.

The availability of local support and care infrastructures at the place of residence is an important issue for the elderly living in rural areas. Spatial mobility can be seen as a strategy to cope with a lack of local care facilities. This study analyzes the preferences of older people living in long-term relationships concerning support and care arrangements. Furthermore, it is analyzed how far and under which circumstances older couples are willing to relocate their place of residence in response to regional care infrastructures. Using a quasi-experimental survey design, inhabitants of a small rural community aged over 50 years were interviewed and confronted with descriptions of fictitious situations with randomized options for moving residence. A Tobit model estimation method is applied to examine the determinants of older couples' care-related willingness to move their residence.The results show that most people prefer either the support of their own partner or outpatient care. Residential care is especially preferred by people aged 75 years and above, whereas new forms of support, such as senior cooperatives, are evaluated as attractive especially by younger age groups. Thus, information and advisory campaigns should address the target group in question even at an early stage in older peoples' life course. Care-related willingness to move home of couples aged 50 years and more is significantly determined by local provision of support and care infrastructures. The expansion of any care infrastructure at older peoples' place of residence can significantly reduce their willingness to move. In particular an increased availability of outpatient care is associated with a comparatively large reduction in couples' likelihood to move. In this way local commitment to rural areas can be sustained and rural depopulation can be prevented. At an alternative place of residence assisted living and residential care in particular can significantly enhance the willingness to relocate and can thus generate incentives to move for older couples.

Seasonal variation and homes: understanding the social experiences of older adults.

There has been limited research on the importance of seasons in the lives of older adults. Previous research has highlighted seasonal fluctuations in physical functioning--including limb strength, range of motion, and cardiac death--the spread of influenza in seasonal migration patterns. In addition, older adults experience isolation for various reasons, such as decline of physical and cognitive ability, lack of transportation, and lack of opportunities for social interaction. There has been much attention paid to the social isolation of older adults, yet little analysis about how the isolation changes throughout the year. Based on findings from an ethnographic study of older adults (n = 81), their family members (n = 49), and supportive professionals (n = 46) as they embark on relocation from their homes, this study analyzes the processes of moving for older adults. It examines the seasonal fluctuations of social isolation because of the effect of the environment on the social experiences of older adults. Isolation occurs because of the difficulty inclement weather causes on social interactions and mobility. The article concludes with discussion of the ways that research and practice can be designed and implemented to account for seasonal variation.

Boomers' prospective needs for senior centers and related services: a survey of persons 50-59.

The future service needs of baby boomers are unclear. A survey addressing work/retirement, family, civic engagement, health, caregiving, leisure, and perceptions of senior services was mailed to 800 addresses randomly selected from a upper Midwestern county voter registration list. The response rate was 28%. Fifty-three percent of the respondents (N = 225) intended to work and increase civic engagement. They expected more time for hobbies and friends, and to travel more. Family will continue to be their highest priority. These findings will be useful to service providers who are invested in providing services that are attractive to boomers.

Older Adult Segmentation According to Residentially-Based Lifestyles and Analysis of Their Needs for Smart Home Functions.

Globally, the percentage of older people in the general population is growing. Smart homes have the potential to help older adults to live independently and healthy, improving their quality of life, and relieving the pressure on the healthcare and social care systems. For that, we need to understand how older adults live and their needs. Thus, this study aims to analyze the residentially-based lifestyles (RBL) of older adults and segment them to compare and analyze the real needs of smart home functions for each group. To identify a person's RBL, a questionnaire was designed to include questions about activities at home, social events, quality of life, etc. This study surveyed 271 older Koreans. As a result of the survey on RBL, five groups with different characteristics were clustered. Finally, each groups' features and the differences in their needs for smart home functions were compared and analyzed. The priority of needed functions for each group was found to be significantly different. In a total of 26 smart home functions, there were meaningful differences in the needs for 16 functions among the groups. This study presents the results in South Korea, according to older adults' RBL and their smart home needs.

Development of a smart home simulator for use as a heuristic tool for management of sensor distribution.

Smart Homes offer potential solutions for various forms of independent living for the elderly. The assistive and protective environment afforded by smart homes offer a safe, relatively inexpensive, dependable and viable alternative to vulnerable inhabitants. Nevertheless, the success of a smart home rests upon the quality of information its decision support system receives and this in turn places great importance on the issue of correct sensor deployment. In this article we present a software tool that has been developed to address the elusive issue of sensor distribution within smart homes. Details of the tool will be presented and it will be shown how it can be used to emulate any real world environment whereby virtual sensor distributions can be rapidly implemented and assessed without the requirement for physical deployment for evaluation. As such, this approach offers the potential of tailoring sensor distributions to the specific needs of a patient in a non-evasive manner. The heuristics based tool presented here has been developed as the first part of a three stage project.

Affordable rental housing for older people in Australia: what do older people want?

This study aims to determine the perspectives of older community members and service providers in relation to design and location of affordable rental housing in a coastal retirement area of NSW, Australia. This was achieved by holding focus groups and interviews with older community members (n = 21) and service providers (n = 43). All participants reported a shortage of affordable rental housing suitable for older people in the area. The preferred option was for cluster units, possibly with an on-site carer, located in or close to town. Participants agreed that if choice was limited to "one-bedroom with large living area" or "two-bedrooms with small living area," the majority of single older people would choose the former option, provided there was adequate storage. The importance of asking the "right" question was demonstrated by responses to options for one- or two-bedroom units. Further research is needed to identify what baby boomers think will meet their need for future affordable housing.

Social capital and successful aging: the role of senior housing.

Social capital is defined as the resources available to individuals and groups through social connections and social relations with others. Access to social capital enables older citizens to maintain productive, independent, and fulfilling lives. As the U.S. population ages, accompanied by a rise in the prevalence of seniors living alone, the availability of social capital within communities will become an important ingredient of successful aging. Recent evidence suggests that many traditional forms of social capital in communities-as represented by civic engagement in local associations and by the extent of voluntarism and social trust-are on the decline. If this observation in correct, there is no simple solution to rebuilding this lost social capital. Novel forms of senior housing, such as planned care developments and assisted-living facilities, may offer promising modes of delivery of social capital to the aging population. However, assisted living remains financially inaccessible for a large segment of the U.S. population, so investment in communities "aging in place" may be the key to delivering the health dividends of social capital.

Long term care: the case of the elderly.

Health care for the elderly in industrialized countries has been characterized by a variety of persistent myths, nurtured by an amazing blindness for facts, and pertaining to their number, the related morbidity, the models of care, the unbearable costs and the financial situation of the elderly. Today a more optimistic perspective about the elderly is emerging emphasizing an older person with a remarkable physical and mental fitness and living in satisfying housing and income conditions. There is a less alarming prognosis about the increase of the elderly population and the share of elderly in the increase of health care budgets seems to be incremental. A wide spectrum of models of care has unfolded over Europe and the plausible explanations for the differences relate to the North-South gradient, the cultural patterns, the history of the health care system and the level of economic development. Europe is focusing on community care: in northern Europe to substitute for institutional care and in southern Europe as a response to changing family patterns. There is a danger of overshooting with policies for the aged, but more than special attention is to be given to the vulnerable risk groups which are the octogenarians, suffering from dementia and poor in housing assets.

[Successes and problems gerontological system services of social protection of the population]. / Uspekhi i problemy gerontologicheskoi sluzhby sistemy zashchity naseleniia.

In analytical review is presented activity gerontological service of social protection of the population (social-gerontological service), on condition on 01.01.2003, and track record of her development for 1991-2002. It Is given detailed feature to activity each of structures, forming this service (stationary institutions of the social service, social care centres, branches home service, day-time branches for the aged, branches acute care and others), as on country as a whole, so and in cut separate regions and federal areas. The reflected main successes and trends of the development social-gerontological service, as well as problems, which permit depends on relations state to senior generation.

Reform survival strategies.

Healthcare reform. How will it really affect you and your organization? To find out how some healthcare executives are responding to the Clinton healthcare reform plan, we talked with ACHE affiliates from investor-owned and not-for-profit systems and long-term care, managed care, and rural hospital settings. Here's what they had to say.

Managed care and assisted living: trends and future prospects.

With its emergence as a new, residential long-term care option, more than half of the states have established policy on assisted living. In 1996, over 30 states had created a state licensure category or passed legislation authorizing development of regulations. Known primarily as a resource for wealthy elders needing assistance with activities of daily living and health care needs, assisted living is increasingly being covered as a service under state Medicaid programs. Assisted living is widely seen as a resource for managed care organizations enrolling Medicare beneficiaries. Flexible capitation payments and incentives to substitute services create opportunities for assisted living facilities and HMOs to form partnerships. Enrollment of beneficiaries in Medicare HMOs has reached 4.5 million and is growing over 30% a year. In addition, state Medicaid agencies are developing programs to enroll elders, most of whom are also Medicare beneficiaries, in managed care programs that include long-term care. The move toward managed care and the increasing interest in integrating acute and long-term care for dual eligibles signals a growing role for assisted living facilities as a major resource for elders who need a supportive and service-rich residential living environment.

Congregations opening facilities to the public.

Roman Catholic congregations are seeking innovative, cost-effective ways to address the growing long-term-care retirement needs of their sisters. The Sisters of St. Joseph of Carondelet in St. Louis have adopted one popular strategy--opening the congregation's retirement and nursing facilities to the private-paying public, which will allow the group to lower its retirement costs and offer a broader range of services.

The bottom line on assisted living.

Seniors increasingly shun nursing homes for the homier settings and greater autonomy of assisted living. But the comforts of home don't come cheap. Most seniors opting for assisted living pay out of their own pockets--making their situations only as stable as their bank accounts.