Factors Affecting California College Students' Attitudes Toward Assisted Dying.

This study focuses on college students' experiences and beliefs, which affect attitudes toward assisted dying. Of 324 students, 35% wanted the option of assisted dying for a family member with a life-threatening illness. Results of multiple logistic regression indicate students who favored assisted dying were significantly influenced by having a family member die, experiencing hospitalization, thinking about end-of-life issues, and being comfortable with palliative care. Belief in an afterlife and being a caregiver were negatively associated with assisted dying. Students need to receive training in end-of-life care issues, as increasingly professionals will face such requests.

University Students' Attitudes Toward Palliative Care.

This study examines the experiences and beliefs of university students which affect attitudes toward palliative care. A total of 322 students responded to a survey on palliative care and end-of-life attitudes. Almost 40% of the students reported not having enough knowledge about options at the end of life. Results of multiple regression indicate students who have more negative attitudes toward palliative care did not believe in end-of-life care planning. Female students and those who had a family member or friend who used palliative care had more positive attitudes toward palliative care. Understanding student perceptions of palliative care allows for developing curriculum sensitive to learners' needs and addressing misconceptions.

Individuals with Alzheimer's learn to play a tile placement game: Results of a pilot study: Innovative practice.

With the ongoing need to determine effective memory interventions for persons with dementia and other memory impairments, the purpose of this study was to create a unique learning opportunity, where persons with early to moderate Alzheimer's engaged in game play activity. Six female participants, diagnosed with early to moderate dementia, were recruited from an adult day care center and participated in a 10-week study. The participants were placed in groups of three and were taught a tile placement game. Results indicate playing the game yielded inconsistent, but some significant, increases and eventual plateauing of knowing when it was their turn. The results also indicate the participant's maintained improvement in tile placement over the study period. Tile placement accuracy increased over rounds, which points to the importance of practice to maintain learned behavior. The game provided a platform for learning, social engagement, and occupied their time meaningfully.

Social engagement during game play in persons with Alzheimer's: Innovative practice.

This study examined social engagement during game play among persons with Alzheimer's. In addition to being engaged with the game, engagement with players was noticed. Players would congratulate each other when they won, and they encouraged each other to do well. Natural conversation occurred as a result of playing the game. The researchers observed that as placement accuracy increased, the players developed a friendly competition. They played to win and experienced a sense of accomplishment when they correctly matched tile pieces. Interestingly, the game provided the players an opportunity to help each other. When a player was unable to figure out where to place a tile, oftentimes the other players would remind them of the rules and assist in tile placement. The ability to help and share knowledge is an opportunity often denied to persons with Alzheimer's.

Factors affecting physician visits in Chinese and Chinese immigrant samples.

This study examines predictors of Western physician utilization using the Andersen's Behavioral Model of Health Services Use for Chinese elders who reside in Shanghai and immigrant Chinese elders who reside in the US Chinese elders are under-studied relative to their population size and in the US are known to underutilize the healthcare system. Underutilization is highly correlated with poor health and well-being. A unique dataset allowed us to examine predictors of physician utilization for Chinese elders who resided in different countries, in an effort to determine how being an immigrant affects utilization. One hundred and seventy-seven Chinese elders in Boston and 420 Chinese elders in Shanghai participated in the survey. Multiple regression analyses were conducted separately for each sample. Predictors of physician visits for the Boston sample are insurance status, health, and social network, and for the Shanghai sample, use of Chinese medicine, health, and marital status predicted physician visits. We found that access to care variables significantly affects physician utilization for immigrant elders, and that Chinese elders in Shanghai utilize a bicultural system of care. The results indicate that in order to create effective healthcare practices for elder Chinese, alternative healthcare beliefs should be understood by Western physicians.

Regional differences in functional status among the aged.

This study investigated regional differences in functional status among aged Medicare beneficiaries in the United States, and the degree to which population risk factors and certain geographic/environmental attributes of communities accounted for the regional differences. Four years of the Medicare Current Beneficiary Survey (1992-1995) were pooled together yielding 37,150 person-year observations of functional status for a sample of aged Medicare beneficiaries residing in the community or nursing homes. Multinomial logit models, estimated on a four-category functional status scale, produced strong empirical evidence of substantial regional differences in the prevalence of functional independence, functional limitations, IADL limitations, and ADL limitations, that could not be attributed to regional population composition, socio-demographic factors, lifestyle characteristics, and chronic medical conditions. Although such population risk factors accounted for much of the regional variations in functional status among older men, the notably higher prevalence of IADL and ADL limitations among older women residing in the Deep South could not be similarly attributed to such risk factors. Rather, the empirical results suggest that a significant portion of the harmful effects associated with residence in the Deep South among older women may be attributed to a higher prevalence of residence in counties characterized by lower population density and/or higher poverty concentration.

The effect of religious coping on caregiving appraisals of mothers of adults with developmental disabilities.

PURPOSE: This article explores the association between race and religious coping on caregiving appraisals for mothers who coreside with an adult child with mental retardation. DESIGN AND METHODS: 71 Black and 71 White women (aged 50 or older) were matched on demographic characteristics to control for the association between race and socioeconomic status. Structural equation analysis was used to examine the relationship between race, religious coping, and caregiving appraisals. RESULTS: Black women were more likely to use religious coping. Religious coping was associated with higher levels of caregiving satisfaction, but not with burden. Blacks experienced higher levels of caregiving satisfaction. Blacks also experienced higher levels of caregiving burden due to their poor health. IMPLICATIONS: The needs of Blacks should be considered when developing "best practices" in service provision. Culturally sensitive outreach approaches should not ignore the importance of faith and faith-based organizations in the lives of Blacks.

Early childhood experiences, cultural beliefs, and oral health of Mexican American women.

This qualitative article examines how financial resources, cultural beliefs, and early childhood experiences affect perceptions of oral health and dental utilization of middle-aged and older Mexican American women. Fourteen in-depth qualitative interviews were conducted. The women's ages range from 49 to 87 years. Most had not visited the dentist in more than 2 years. Most women's early childhood experiences did not include dental visits or dental instruction. Some believed tooth loss was a normal aging process. Misconceptions regarding preventive care, the belief that dental visits were only necessary when experiencing pain, and finances were the primary reasons for not visiting the dentist. The results lend insight into the oral health, self-care practices, and dental utilization of middle-aged and older immigrant Mexican American women.

The social and psychological effect of an adult child's emigration on non-immigrant Asian Indian elderly parents.

The impact of immigration on parents left behind has been largely ignored in the literature. This exploratory study uses cultural specificity theory to examine the effect an adult child's emigration has on the familial support system available to the parents left behind, and on the parent's psychological well-being. Twenty-nine parents (age 55+) in India, who had adult children in the United States, were selected using snowball sampling. Qualitative interviews based on a semi-structured interview schedule were conducted during the fall and winter of 1997. Results show that although most parents do not live in an extended family, they receive support from extended family members. However, the biggest source of daily support comes from hired help. Hired help allows parents to live independently and decreases reliance on informal support systems. Since hired help is relatively inexpensive most parents can substitute help for their children. This does not alleviate feelings of loneliness and depression.

Home health and home care in Massachusetts after the Balanced Budget Act of 1997: implications of cost containment pressures for service authorizations.

This paper explores the response of the Massachusetts state-funded home care program for the elderly when its clients encountered barriers to the receipt of home health services because of HMO enrollment and the implementation of the Balanced Budget Act of 1997. Clients of three regional case management agencies serving the Massachusetts state home care program whose home care services were interrupted because of hospitalization between January 1 and April 30, 1999 and whose services were resumed after they returned home were studied. Detailed data are reported that show how the long-term personal assistance services provided through the state program were often complemented by temporary home health services after elders returned home. The multivariate analysis revealed that the authorization of state-funded personal care services was keyed to the status of home health aide services. After hospitalization, the presence of a home health aide reduced the likelihood of authorization of personal care. At final assessment, the situation was reversed, that is, the withdrawal of a home health aide increased the likelihood of authorization of personal care. The findings suggest that more restrictive Medicare reimbursement policies for home health services led to greater state expenditures for personal care services. In other words, less generous Medicare financing shifted a greater portion of the burden of financing home care to the state of Massachusetts. These findings raise important policy questions about the balance of responsibility between the federal government and states to provide financing of home care services for the elderly.