Risk of Social Isolation among Older Patients: What Factors Affect the Availability of Family, Friends, and Neighbors upon Hospitalization?

OBJECTIVES: To examine the prevalence of social isolation among older patients admitted to a hospital, and the effects of sociodemographic and health-related factors on the availability of their family, friends, and neighbor networks. METHODS: Analyses are based on interviews with a sample of 2,449 older patients admitted to an urban academic medical center in the United States. A nine-item version of Lubben's Social Network Scale was developed and used to assess the availability of different social networks. RESULTS: About 47% of the sample was at risk of social isolation. The oldest old and non-White older adults showed greater risk. The availability of family networks was associated with age, sex, marital status, and prior hospitalization; friend networks with age, race, education, prior hospitalization, and functional limitations; neighbor networks with race, education, marital status, and functional limitations. CONCLUSIONS: The risk of social isolation and the availability of social support for hospitalized older adults varies by both patient and network characteristics. Health professionals should attend to this risk and the factors associated with such risk. CLINICAL IMPLICATIONS: By assessing the availability of various types and frequency of support among older patients, health professionals can better identify those who may need additional support after discharge. Such information should be used in discharge planning to help prevent unnecessary complications and potential readmission.

Impact of Mid-Life Symptoms of Alcoholism on the Health and Wellbeing of Aging Parents of Adults with Disabilities.

The study examined the effect of adult children's disability on parents' physical health in later life and the extent to which parents' symptoms of alcoholism in mid-life moderates the link between children's disability and later life parental health. Analyses are based on data from the Wisconsin Longitudinal Study. The analytic sample included parents of children with developmental disabilities (n = 145) or mental health problems (n = 200) and 2,432 parents of unaffected children. The results showed that the negative health consequences in later life of having a child with a developmental disability were greater for those who showed more symptoms of alcoholism in mid-life. However, symptoms of alcoholism in mid-life did not significantly moderate the impact of an adult child's mental health problems on parents' later life physical health. The findings suggest a potential area where gerontological social workers could intervene, given the negative impact of symptoms of alcoholism on the health of aging parents of children with a disability who may be significantly more susceptible to the negative health impacts of alcohol compared to their younger counterparts.

Do personality traits moderate the impact of care receipt on end-of-life care planning?

PURPOSE OF THE STUDY: This study examines (a) the association between being a care recipient and end-of-life care planning (EOLCP) and (b) the extent to which personality traits moderate the relationship between care receipt and EOLCP. DESIGN AND METHODS: Data are drawn from the Wisconsin Longitudinal Study, a survey of Wisconsin high school graduates from 1957 to 2004. We used data on EOLCP among older adults in the most recent (2003-2004) wave of this survey. Hierarchical logistic regression models are used to estimate the effects of care receipt and the moderating effects of personality. RESULTS: Compared with their peers who are not receiving care, care recipients are more likely to engage in informal discussion on EOLCP. This association between care receipt and informal EOLCP is strengthened when the individual scores high on openness. IMPLICATIONS: Health practitioners should take into account older adults' care needs and differing personality traits while helping older adults make successful EOLCP.

Disparities in health-risk behaviors, preventive health care utilizations, and chronic health conditions for people with disabilities: the Korean National Health and Nutrition Examination Survey.

OBJECTIVE: To examine how disability status is related with health disparities in South Korea. DESIGN: The study compared 3 indicators of health (health-risk behaviors, preventive health care utilizations, and chronic health conditions) according to the presence of disabilities using the Third Korean National Health and Nutrition Examination Survey, 2005 (KNHANES III). SETTING: We obtained data from the KNHANES III, which is the third nationwide representative study using a stratified, multistage probability sampling design. PARTICIPANTS: Subjects (N=5475) aged 20 years or older were included in the study; persons with disabilities (n=218) and persons without disabilities (n=5257). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Nonconditional multiple logistic regression and adjusted mean were used to identify health disparities in health-risk behaviors, preventive health care utilizations, and chronic health conditions. RESULTS: Subjects with disabilities were more likely to be physically inactive (adjusted odds ratio [AOR]=3.06; 95% confidence interval [CI], 1.71-5.48 for no physical activity; AOR=1.70; 95% CI, 1.19-2.43 for insufficient physical activity) than those without disabilities. Women aged 40 years or older with disabilities were less likely to receive cervical cancer screening services (AOR=0.52; 95% CI, 0.27-0.98). Adults with disabilities had higher proportion of osteoporosis (AOR=2.41; 95% CI, 1.50-3.88), underweight (AOR=2.14; 95% CI, 1.07-4.28), suicidal thoughts (AOR=1.86; 95% CI, 1.35-2.56), and had impaired quality of life (95% CI of adjusted mean, 60.89-65.35 compared to 69.95-70.84 in adults without disabilities). CONCLUSIONS: There exists substantial disability-related health disparities in South Korea. People with disabilities may be the underserved subpopulation demonstrating health disparities. The findings in this study underscore the continued needs in order to reduce health problems and disparities for people with disabilities.

Relationship between spouse/partner support and depressive symptoms in older adults: gender difference.

Based on data from the National Social Life, Health, and Aging Project, Wave 1, the purpose of this study was to examine possible gender difference in the relationship between the level of spouse/partner support and depressive symptoms in late life. Depressive symptoms were measured by the 11-item, four-point Center for Epidemiologic Scale for Depression (CES-D), and spouse/partner support was measured by a four-item scale, an abbreviated version of the original spouse support/strain scale developed by Schuster, Kessler, and Aseltine (1990). The results from regression analyses show that low perceived spouse/partner support, as opposed to unavailability of the support, was associated with higher CES-D scores among women only, while high spouse/partner support was associated with lower CES-D scores for both genders. These relationship patterns were found in both younger and older groups of men and women.