Suicidal Ideation Among Older Adults in Prison: A Qualitative Study.

Suicide is a serious public health concern, and people who are incarcerated represent a particularly high-risk group. Although research on the suicidality of persons in prison has gained interest in recent decades, the issue of suicide among older adults in prison has been understudied. Therefore, the aim of the present study was to explore the ways in which older adults in prison understood their experiences of suicidal ideation. Interpretive phenomenological analysis was utilized to analyze interviews with 16 incarcerated older adults. The analysis of the findings revealed four themes: (1) Suicide intentions as a control strategy; (2) Suicide intentions as an act of resistance; (3) Suicide intentions as a means of self-redemption, and (4) Suicide intentions in the absence of other choices. Guided by the life course perspective, the findings suggest that suicidal ideation serves as a means of expressing distinct emotional states that may be unique to older adults in carceral environments.

The Emotional Aftermath of Surviving an Attempted Intimate Partner Homicide.

While the issue of intimate partner homicide (IPH) has gained increasing focus, research that pinpoints the experiences of women who survived an attempted IPH is limited. Specifically, studies that aim to understand the aftermath of surviving such incidents are scarce. Thus, the aim of the present study was to explore the emotional experience of IPH survivors following the attack. An interpretive phenomenological analysis was used to analyze the narratives of 11 women who had survived an attempted homicide by their partner. Four major themes emerged: Living between dichotomies: A fragmented identity; Embodied fear: A fear that will not go away; The loss of future: A life divided; and The loneliness of surviving the "unsurvivable." Utilizing the ambiguous loss theory to examine the emotional ramifications of IPH indicates that survivors navigate persistent confusion and struggle to comprehend the loss. This involves challenges in moving forward and achieving resolution, conflicting emotions related to the loss, minimal recognition of the grief, and limited support from the social environment.

Prostitution in the shadow of life-long sexual abuse: Arab women's retrospective experiences.

The present study uses the life-course and intersectionality perspectives to explore the meaning that aging Arab women attribute to their lived experiences of life-long sexual abuse in the shadow of engaging in prostitution. Interpretive phenomenological analysis was used to analyze the narratives of 10 older Arab women in Israel who were engaged in prostitution. Four themes emerged: experiencing childhood in the shadow of sexual abuse, becoming a prostitute, being entrapped in prostitution, and settling accounts with the native culture. Women aging in prostitution experience a harsh reality of abuse and loss. The present study points to multiple channels of abuse throughout the life course, from childhood until old age.

I'm a 45-year-old woman in the body of an 80-year-old: The multiple losses of living and aging in the shadow of prostitution.

INTRODUCTION: Research on aging women who are involved in prostitution is currently limited, both in terms of the number of studies conducted and their scope. Nevertheless, the available research suggests that women who are aging while involved in prostitution may confront some unique challenges. Thus, the study aims to explore the experiences of aging as narrated by Arab women in prostitution, using Intersectionality as a theoretical framework. METHOD: Interpretive phenomenological analysis was used, and semistructured interviews were performed with 12 participants. FINDINGS: Four themes emerged: "I'm a 45-year-old woman in the body of an 80-year-old:" Loss of physical and mental health; "There is no retirement plan in prostitution: Economic and social losses; As they were taken, my soul went with them too: The loss of the parenting experience and motherhood"; and "I'm going to get older with the disgust clinging to me:" The loss of authentic identity and dignity. CONCLUSION: The findings demonstrate how aging serves to exacerbate overlapping forms of discrimination and marginalization. CLINICAL RELEVANCE: Healthcare professionals, including nurses caring for older women in prostitution, should be aware of their unique circumstances, considering the social, economic, and healthcare obstacles they face. By being cognizant of these factors, healthcare practitioners can provide meaningful assistance in their pursuit of improved quality of life.

The Multiple Punishment of Being an Older Adult Coping With Health Problems in Prison.

BACKGROUND AND OBJECTIVES: Studies have examined the vulnerabilities and the extent of health problems experienced by the older adult population in prison. However, reports about the subjective experiences of incarcerated older adults who are coping with health problems are scarce. This is alarming since older adults comprise the fastest-growing demographic in the prison systems of the United States and Europe. The aim of the current study was to bring forth the voices of older adults who are living with diseases in prison and to outline the landscape of struggling with everyday health care management. RESEARCH DESIGN AND METHODS: An interpretive phenomenological analysis was used to analyze the narratives of 23 individuals aged 60-88 who were coping with health problems in prison. RESULTS: The narratives revealed 3 major themes: (1) living day to day with illness in prison: fighting prison bureaucracy and public humiliation; (2) coping with complex medical issues: lack of professional medical care and cumulative problems, and (3) what does the future hold? Fear of living with illness out of prison. DISCUSSION AND IMPLICATIONS: Intersectionality was used as a conceptual framework for understanding the participants' narratives. The cumulative effect of belonging to systematically oppressed and marginalized groups is discussed. The research findings point to issues and experiences that are unique to older adults coping with health problems in prison and can serve as a framework for developing tailored interventions for these individuals.

The role of substance use in the lives of incarcerated older adults: A qualitative study.

Background: The prevalence of drug abuse among older adults has grown over the last decade. Despite the expanding development of a body of research dedicated to studying this phenomenon, drug abuse by incarcerated older adults has been marginalized. Thus, the aim of the present study was to explore drug abuse patterns in the lives of incarcerated older adults. Method: Semi-structured interviews were conducted with 28 incarcerated older adults, and an interpretive analysis was used to analyze the participants' narratives. Findings: Four themes emerged: (1) Growing up around drugs; (2) Prison onset; (3) Professionals, and (4) Lifelong substance abuse. Conclusion: The study findings reveal a unique typology of drug-related themes in the lives of incarcerated older adults. This typology sheds light on the interplay between aging, drug use, and incarceration and the way these three socially marginalized positions may intersect.

Recovering the Lost Soul: Older Women's Reflections on Past Intrafamilial Child Sexual Abuse.

Intrafamilial child sexual abuse (IFCSA) is a social problem with longstanding effects on victims' lives. While scholarly literature has focused on the adverse aftermath of sexual abuse, only a few studies have acknowledged older women's perspectives on their experience of IFCSA and their journey of healing and recovery. The aim of the present study was to explore how older survivors of IFCSA construct and shape their experience of healing in later life and the meaning they assign to this process. Narrative inquiry was selected to explore the narratives of 11 older women survivors of IFCSA. Participants were interviewed using a biographical narrative interviewing method. The narratives were then transcribed and analyzed using thematic, structural, and performance analyses. Four major themes emerged from the participants' narratives: Achieving closure; Spiritual framing of IFCSA as a platform for self-growth; Becoming whole in old age; and Looking to the future after IFCSA. During the aging years, IFCSA survivors may redefine their identity and their place in the world. Using life review processes, older women in this study were striving to heal and reconcile with their past.

Prisoners' experience of health self-management: A qualitative study.

PURPOSE: Among the noninstitutionalized population, health care is increasingly shifting from a paternalistic model toward promoting patients' involvement in decision-making and in managing their condition. This paradigm shift toward health self-management is less applicable to individuals in prison whose health management choices are limited. The aim of this study was to explore prisoners' health self-management needs and the strategies used to maintain health self-management in a highly restrictive prison environment. DESIGN: A qualitative phenomenological study design was selected for this research. METHODS: An interpretive phenomenological analysis was chosen to present the narratives of prisoners regarding their health self-management. Semi-structured interviews were conducted with 15 male prisoners followed by content analysis. RESULTS: The analysis of the participants' narratives revealed four major themes: (1) "I thrive on the anger so I can turn it into some more sit-ups:" Initiating sporting activities (2) "Food shouldn't be that white…:" Prisoners' quest for healthier eating (3) "I felt I want more out of life…:" Avoiding an unhealthy lifestyle (4) "I want to be taken care of:" The struggle for better health care. CONCLUSIONS: The findings suggest that prisoners can overcome the challenges of maintaining health in prison and become committed to better health management. Prisoners who serve as health resources may help reduce the load on correctional facilities' health care systems and the public.

Juggling between caregiving and self-actualization: Older parents' lifelong experience of caring for an adult child with developmental disabilities.

Recently, the number of adults with Developmental Disabilities (DD) who live with their parents has increased. This study aims to explore how parents report retrospectively and interpret their experience in the context of self-actualization in the long-term care of a child with a developmental disability. Four forms of parents' experiences emerged from the analysis: "This child is my whole world"-Total devotion; "I Can Do Both"-Actualizing personal and familial goals as well as caregiving issues; "It's a mission, it's a calling, it's a full-time job"-Self-actualization through caregiving; and "Disability will not stop me"-Emphasizing self-actualization. While prior studies have created a distinct separation between caregiving and self-actualization, the current study focuses on the complex dynamics of lifelong parental caregiving for a child with DD, illustrating the parents' ways of actualizing their life goals in the context of caregiving over the years.

The Lived Experience of Older Women Who Are Sexually Abused in the Context of Lifelong IPV.

The present study explores the lived experience of older women who are sexually abused in the context of lifelong intimate partner violence (IPV). An interpretive phenomenological analysis was used, and semi-structured interviews were performed with 19 older women survivors of lifelong IPV and sexual violence. Three themes emerged: sexual violence shaping lifelong IPV, the occurrence of sexual violence in old age in the context of lifelong IPV, and cumulative insights and reflections on being a survivor of lifelong IPV and sexual violence. The transition to aging has a profound impact on the violent relationship dynamics and this should be considered in practical interventions.

Growing Older in the Shadow of Childhood Intrafamilial Sexual Abuse: Women's Reflections on Parenthood Experiences Throughout the Life Course.

BACKGROUND AND OBJECTIVES: The long-term effect of intrafamilial sexual abuse for the survivors' parenting rarely focuses on older women who are mothers of adult children. The aim of this study was to explore the parenthood experiences of aging women survivors of intrafamilial sexual abuse, using the life course perspective as a conceptual framework. RESEARCH DESIGN AND METHODS: Interpretive phenomenological analysis was used to analyze the narratives of 19 older women survivors of intrafamilial sexual abuse. RESULTS: The narratives revealed 4 themes: (a) "How did I raise those kids? I really do not know": Early parenthood experiences of aging women incest survivors; (b) "This is a true gift they are giving me now": Revealing the intrafamilial sexual abuse secret to the adult children; (c) "Is it possible to say that something good came out of it?": Adult children as a victory over incest experiences; and (d) "When my granddaughter was born, I suddenly felt that I could not go near her": Grandparenting in the shadow of incest memories. DISCUSSION AND IMPLICATIONS: Aging seems to open up a new avenue for parent-child relationships in the shadow of the parent's traumatic past, allowing reframing of parenthood in later life and demonstrating the power of parenthood as a source of healing in the lives of sexual abuse victims.

Women Coping With a Partner's Dementia-Related Violence: A Qualitative Study.

PURPOSE: The aim of the present study was to differentiate between the lived experience of two groups of women caregiving for a partner with dementia. One group was coping with lifelong intimate partner violence (IPV) and dementia-related violence (Group 1); the other group was coping with dementia-related violence only (Group 2). DESIGN: An interpretive phenomenological analysis perspective was used. Data collection was performed through in-depth, semistructured interviews with eight female spouses of men with dementia from each of the two above-mentioned groups, followed by a content analysis. FINDINGS: Comparing the narratives of the aging women revealed their different experiences over several dimensions: (a) the identification of violence as a symptom of dementia; (b) the use of past couplehood memories; (c) feelings over time; (d) willingness to care for the partner with dementia; and (e) a prospective view of life. CONCLUSIONS: The complexities of being old and having to cope with caregiving responsibilities for a spouse with dementia, accompanied by violent behaviors, emphasize the significance of the couple's past relationship. This notion should be taken into account in practical interventions. CLINICAL RELEVANCE: As part of the aging process, there is an increase in people who are engaged in dementia-related violence. Nurses' education and practice should focus on the dynamics of dyads coping with violence and identify the particular needs of the caregiver spouse in this context.

Sibling Relationships Over the Life Course: Growing Up With a Disability.

The research explores sibling relationships, and the ways in which they are shaped over the life course by family members, in families with a lifelong disability. In-depth, semistructured interviews were conducted with 15 family units including a parent, a sibling, and an adult sibling with a disability. The content analysis revealed five sibling relationship patterns: (a) "Not a child, but a parent caretaker"-the parent-surrogate sibling; (b) "We somehow grew apart"-the estranged sibling; (c) "It is important for me to maintain some kind of distance"-the bystander sibling; (d) "When there's something they want to tell him, they always send me"-the mediator sibling; and (e) "I love him to death"-the friend sibling. These patterns of adult sibling relationships are discussed in relation to family dynamics, values, and legacies; recommendations for practice and research are made.

"Like Every Normal Person?!" The Paradoxical Effect of Aging With Schizophrenia.

Studies on aging with schizophrenia have focused mainly on the adversities of aging with mental illness. The present study, however, examined the subjective experience of well-being among individuals with schizophrenia. Taking a phenomenological reflective life-world approach, in-depth, semistructured interviews with 18 aging individuals with schizophrenia were thematically analyzed. Four main themes emerged: (a) "I love the pills . . . they are very helpful": A balanced course of the illness as a basis for well-being in old age; (b) "I'm going to have my own exhibition at the museum": Self-fulfillment as promoting well-being; (c) "It's just like a family here": Experiencing a sense of belonging; and (d) "I live like everyone else": Aging as an opportunity for normalization. Alongside hardship, the participants perceived old age as a "window of opportunity," enabling the fulfillment of lifelong desires for a social life, acceptance, and a satisfying occupation. Implications regarding interventions with this unique population are discussed.

The Experience of Parenting a Child With Disability in Old Age.

BACKGROUND: There are growing numbers of older parents providing ongoing care for adults with disabilities. A parent's aging calls for a redefinition of parental care practices and roles in light of his or her own changing needs. PURPOSE: The current study aims to highlight the ways in which aging parents perceive and construct their parental role to adult children with disabilities at this point in their lives. METHODS: An interpretive phenomenological analysis perspective was used. Data collection was performed through in-depth, semistructured interviews with 20 aging parents of children with developmental disabilities, followed by a content analysis. RESULTS: Four patterns of parental identity emerged: "Being happy is his responsibility; I did my part," embracing aging needs; "I can do part-time worrying," a gradual letting go of parental roles; "I'm worn out, but I keep going. What choice do I have?" bearing the brunt; "I'm an old woman changing diapers," full-time parents. CONCLUSIONS: The findings enable a deeper understanding of the various ways in which parents cope with aging alongside caring for an adult child with disability. Hence, this study can serve as a framework for developing tailored and differential intervention methods for these families. CLINICAL RELEVANCE: As the world's people experience longer life expectancy, of both individuals with disabilities and their parents, nurses' education and practice should be challenged by the double sensitivities of elder's caregiving and address the unique needs of this unique population.

Aging With Schizophrenia: A Lifelong Experience of Multidimensional Losses and Suffering.

The aim of this study was to explore the subjective experience of suffering in aging individuals with schizophrenia. Qualitative interviews were conducted with 18 participants aged 60-69. Phenomenological content analysis was performed. Nine dimensions of suffering emerged: social rejection; familial rejection; the symptoms of schizophrenia; hospitalisation; the side effects of medication; loss of employment potential; loss of independent accommodation; loss of social life, and loss of hope to be a partner and a parent. The suffering of aging people with schizophrenia is cumulative and ongoing and thus evokes issues such as existential loneliness and feelings of homelessness.

How aging individuals with schizophrenia experience the self-etiology of their illness: a reflective lifeworld research approach.

OBJECTIVE: In recent years, there are an increasing number of individuals with schizophrenia who are aging within the general society. Self-etiology of the illness refers to its causal attributions by this population as part of the life review process. The aim of this paper is to develop knowledge from the perspective of older people with schizophrenia regarding the self-etiology of their illness. Focusing on the self-etiology of this particular population is useful, to enhance the understanding of their lived experience in the context of their lifeworld. METHOD: The study was carried out using the reflective lifeworld phenomenological approach. In-depth semi-structured interviews were conducted with 18 aging individuals with schizophrenia followed by analysis for meaning. RESULTS: Five major constituents of the phenomenon under study - the experience of self-etiology among aging people with schizophrenia - emerged from the findings: 'It leaves you to your fate' - schizophrenia as a decree of fate; 'I have sinned against God' - schizophrenia as a punishment from God; 'They put something in my coffee' - schizophrenia as a result of witchcraft; 'Her genes are in me' - schizophrenia as genetic; and 'She left me and that's how I got sick' - schizophrenia as a result of personal trauma. CONCLUSIONS: The findings show that self-etiology in old age tends to be stable, externally attributed and culturally oriented, and serves as a central component in the life review process. This is relevant for professionals developing intervention methods for aging people with schizophrenia.

Harmed? Harmful? Experiencing Abusive Adult Children With Mental Disorder Over the Life Course.

Older parents of an adult child coping with a mental disorder that is expressed by violent deviant behavior face significant parenting challenges. The purpose of this article is to explore the ways older parents exposed to abuse by their adult children with mental disorder (ACMD) perceived their child's violent deviant behavior along the life course. In a qualitative-phenomenological study, 16 parents aged 58 to 90 were interviewed in depth. Three major themes emerged: (a) ongoing total care for the child's needs along the life course, (b) constructions and perceptions of the child through the years-Parents perceived their children over two continua, reflecting their experience of the child's deviant behavior: the child as more harmed versus more harmful, the child as normative versus pathological-and (c) the parent's emotional world toward the harmed-harmful child. The findings enable a deeper understanding of the various ways in which parents cope with living with deviant behaviors of their ACMD. Hence, this study can serve as a framework for developing tailored and differential intervention methods.

Predicting professional quality of life among professional and volunteer caregivers.

This study is one of the few that has compared volunteers' professional quality of life (PQL), which includes secondary traumatic stress (STS), burnout, and compassion satisfaction (CS), to those of professional caregivers. In addition, the research compared the ethical behavior of volunteers with that of professional therapists and examined the connection between years of experience, ethical behavior, and PQL. One hundred eighty-three volunteers and professional caregivers filled out a sociodemographic questionnaire, an Ethical Behavior Questionnaire and the Professional Quality of Life (ProQOL) questionnaire. The results indicated that professional caregivers report lower levels of STS and burnout, and higher levels of CS and ethical behavior compared with volunteer caregivers. Moreover, the findings suggest that ethical behavior correlates with STS, burnout, and CS. Ethical behavior has a protective value for mental health caregivers. The discussion emphasizes the value of a professional code of ethics and ethical training for professional and volunteering caregivers.

Departure scripts and life review of parents living with abusive adult children with mental disorder.

BACKGROUND: Increasing numbers of aging parents are finding themselves in the role of caregiver for their mentally ill adult child due to global deinstitutionalization policy. The aim of this article is to explore preparations for the end of life in light of the life review process among old parents of abusive children with mental disorder. METHOD: Data collection was performed through in-depth semi-structured interviews with 20 parents, followed by phenomenological analysis. RESULTS: Five different types of departure scripts emerged: a pragmatic departure script, a burned-out departure script, a dead-end departure script, an optimistic departure script, and a violent departure script. CONCLUSION: The parents in this study tended to interpret events in their past to fit their perception of the current relationship with their child, thus connecting past, present, and future into one coherent picture. Years of extended care have led to a unique aging process which does not allow separation from the child or the development of a sense of closure that characterizes the aging process. This calls for better insights and deeper understanding in regard to intervention with such families.