Factors associated with formal volunteering among retirees.

The present study developed and tested a comprehensive multivariate model designed to assess the relative importance of various factors found or proposed in previous research to be associated with engagement in volunteering among 799 fully retired Australian older adults (62% female; mean age = 71.92 years (SD = 6.69)). Engagement in volunteering in the 12 months preceding the study and a range of sociodemographic, psychological, physical, social, and attitudinal variables were measured. Respondents' perceived personal responsibility to volunteer was found to be especially important in the tested model. This variable was directly associated with engagement in volunteering and acted as an important mediator between the following variables and volunteering engagement: personal growth, social connectedness, religious attendance, self-rated health, and depression. Efforts to increase volunteering engagement among older adults may therefore need to target perceptions of their responsibility to volunteer. Especially important focus areas for future strategies may include increasing social connectedness, facilitating personal growth, and improving self-rated health.

Improving Attitudes to Volunteering Among Older Adults: A Randomized Trial Approach.

Promoting engagement in formal volunteering represents a potential means of facilitating healthy aging. Given reluctance to participate in volunteering has been partially attributed to negative perceptions of various aspects of this activity, this study assessed whether trialing volunteering can improve perceptions among older people. Using a parallel-group design, Australians aged 60+ years (n = 445) were randomly assigned to one of two conditions, one in which they were encouraged to trial volunteering and one in which they were asked to continue their usual activities. Perceptions and attitudes among those in the volunteering condition became significantly more favorable over 6 months relative to those in the control condition, with this change predicted by several aspects of the volunteering experience (e.g., acquisition of skills, increased social connectedness). Providing access to roles that cater to the learning and social needs of older adults appears to be important for improving attitudes toward engaging in volunteer work.

A randomized controlled trial and pragmatic analysis of the effects of volunteering on the health and well-being of older people.

BACKGROUND: Volunteering among older people has the potential to deliver health benefits to the individual, along with economic and social benefits to society. However, it is not clear whether healthier people are more likely to engage in volunteering, whether volunteering improves health, or the extent to which the relationship may be reciprocal. There is an identified need for longitudinal work, especially in the form of randomized controlled trials, to establish causality. AIMS: To assess the effects of commencing volunteering among older non-volunteers utilizing a randomized controlled trial approach involving per-protocol and pragmatic analyses. METHODS: Of the 445 Australians aged 60 + years who participated in the study, 201 were assigned to an intervention arm that required them to participate in a minimum of 1 h/week of formal volunteering in a position of their choice. The remaining participants were assigned to a control condition and asked to continue their lives as usual, but were not discouraged from commencing volunteering. RESULTS: Across the assessed physical, psychological, and social variables, a significant difference in sit-to-stand scores was found in both the per-protocol and pragmatic analyses, and a further significant difference in the fast pace walk was identified in the pragmatic analyses. CONCLUSION: The results provide some support for policies and programs designed to encourage older people to engage in volunteering to maintain or improve their health. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12615000091505.

Expectations of care within marriage for older couples.

OBJECTIVES: This study explores the intersection of marriage and caregiving amongst older spousal caregivers in regional Australia. Specifically, we address the research question: 'How do expectations of informal care impact spousal caregivers in later life?' METHODS: These comprise interpretive qualitative in-depth interviews in order to understand the lived experience of caregiving within the context of long-term marriage. RESULTS: Findings highlight the complexity and diversity of marital relationships as the context of informal care. Individual and social obligations were evident in key themes, demonstrating how spouses automatically assume and continue in caregiver roles in later life. CONCLUSION: Caregiving is an expectation of couples in long-term marriages, regardless of the relationship quality and willingness to care. Normative expectations also impact decision-making around future care planning and transitions away from home-based care. These are important considerations for both policy and practice with older adults and their caregivers.

Predicting wellness among rural older Australians: a cross- sectional study.

INTRODUCTION: Prior research on older people's wellbeing and quality of life has lacked clarity and consistency. Research examining older people's health has tended to use these different terms and measurement tools interchangeably, which might explain why the evidence is somewhat mixed. There is a paucity of research that uses the multi-dimensional construct of wellness in rural older people. Addressing both limitations, this study seeks to make a unique contribution to knowledge testing an ecological model of wellness that includes intrapersonal factors, interpersonal processes, institutional factors, community factors and public policy. METHODS: Six rural case study sites were chosen across two Australian sites, the states of Queensland and Victoria. A community saturation recruitment strategy was utilised. Telephone surveys were conducted with community-dwelling rural older people (n=266) aged ≥65 years across the sites. The central variable of the study was wellness as measured by the Perceived Wellness Survey. The ecological model developed included the following intrapersonal factors: physical and mental health, loneliness and social demographic characteristics (age, sex, marital status and financial capability). Interpersonal factors included a measure of social and community group participation, social network size and support provided. Institutional factors were measured by series of questions devised around the resource base environment and access to amenities and services. RESULTS: A hierarchical regression analysis was conducted to determine which variables in the model predict wellness. The results showed that a combination of intrapersonal factors (physical health, mental health, loneliness and financial capability) and interpersonal factors (size of social network and community participation) predicted wellness. However, institutional factors, the resource base environment, and access to amenities and services, contributed only marginally to the model. Community factors, including the personal and physical characteristics of community, also only made a marginal contribution. CONCLUSIONS: The study identified the usefulness of using an integrated model of measurement in wellness. This model recognised the interrelated physical, social and economic influences that impact on rural older people throughout their life course. The study found that physical health made the greatest contribution to perceived wellness, followed by mental health. These findings support a body of research that has found that rural older people experience poorer health outcomes than those in urban areas. Lower levels of loneliness were also a strong predictor of perceived wellness, thus supporting research that has examined the impact of loneliness on physical and mental health. The presence of social capital, as measured by social network size, and the degree of community participation, were also predictors of perceived wellness. Overall, the findings of the present study implications for policy as well as subsequent strategies designed to increase the capacity of wellness in rural older people. Such strategies need to consider the contribution of a range of factors.

Combatting social isolation and increasing social participation of older adults through the use of technology: A systematic review of existing evidence.

OBJECTIVES: There are growing concerns that social isolation presents risks to older people's health and well-being. Thus, the objective of the review was to explore how technology is currently being utilised to combat social isolation and increase social participation, hence improving social outcomes for older people. METHODS: A systematic review of the literature was conducted across the social science and human-computer interaction databases. RESULTS: A total of 36 papers met the inclusion criteria and were analysed using a four-step process. Findings were threefold, suggesting that: (i) technologies principally utilised social network services and touch-screen technologies; (ii) social outcomes are often ill-defined or not defined at all; and (iii) methodologies used to evaluate interventions were often limited and small-scale. CONCLUSION: Results suggest a need for studies that examine new and innovative forms of technology, evaluated with rigorous methodologies, and drawing on clear definitions about how these technologies address social isolation/participation.

A far greater sense of community: The impact of volunteer behaviour on the wellness of rural older Australians.

This paper builds on place-based research investigating the transformative potential of volunteering for service-deprived, ageing rural communities. Here, we critically explore the relationship between communities of place, voluntarism and wellness for rural older Australians. We draw on data from a large qualitative multi-site study, and utilise Ryan et al.'s (2005) systemic model of community attachment. Findings support the dual perspective of strong community sentiments through social embeddedness in rural communities; and personal interests, associated with rational choice theory, through healthy ageing practices. Both aspects have demonstrated positive impact on wellness, but also risks to wellness associated with over-expectations of volunteers.

'Although we're isolated, we're not really isolated': The value of information and communication technology for older people in rural Australia.

OBJECTIVE: Drawing from a larger study that identified the supports and services that facilitate wellness among older people from rural communities, this study examined the specific contribution made by information and communication technology (ICT). METHODS: Qualitative interviews were undertaken with 60 older adults from six Australian rural areas. A preliminary thematic analysis was conducted, followed by a higher-order inductive analysis. RESULTS: Information and communication technology use was discussed in terms of individual enrichment, and in terms of enabling connections between the individual and their social networks, community and wider service environments. CONCLUSION: Information and communication technologies may facilitate wellness for rural older people by compensating for geographical and social isolation. In the changing world of health and aged care service delivery, ICTs will be more important than ever for rural older people in building their capacity to access the services, socialisation and support that they need, regardless of location.

Challenges to the provision of community aged care services across rural Australia: perceptions of service managers.

INTRODUCTION: The Australian community aged care sector is facing a growing workforce crisis, particularly in rural and regional areas. Its predominantly female workforce is ageing, and recruiting younger, skilled workers is proving difficult. The service sector, too, is proving highly complex and diverse as a result of contemporary aged care service reforms as well as ongoing difficulties in providing services to the growing numbers of older people living in Australia's rural areas. Despite these multiple challenges, there is a gap in research that explores how rural aged care services manage their day-to-day requirements for skilled workers across the diverse service sector. To address this gap, this article reports on the experiences and perceptions of a small sample of service managers whose organisations represent this diversity, and who are accountable for care provision in regional and rural locations. In such areas, recruitment and skill needs are contoured by disproportionate aged populations, distance and reduced service availability. METHODS: Eleven service managers were interviewed as part of a larger project that examined the skill and training needs of community aged care workers within the Riverina, a rural region in New South Wales. Qualitative data drawn from semi-structured interviews were thematically analysed to identify the managers' individual needs for workers and skills in the context of location, service parameters and availability of other health and community services. RESULTS: Thematic analysis of the interview data elicited three themes: services, roles and skill deployment; older workers and gendered roles; and barriers to recruitment. The findings illustrate the complexities that characterise the community aged care sector as a whole and the impact of these on individual services located in regional and rural parts of Australia. The participants reported diverse needs for worker skills in keeping with the particular level of service they provide. Significantly, their varying perceptions and practices reflect their preference for older, female workers; their reluctance to take on younger workers is negatively skewed by a lack of capacity to compete for, recruit and retain such workers and to offer incentives in the form of enhanced roles and career development. CONCLUSIONS: The findings highlight the conceptual ambiguities inherent in definitions of community aged care work as broadly skilled and uniformly sought across the sector. On the one hand, demands for more and better trained workers to meet growing client complexity locate care work as skilled. On the other, managers of narrowly defined service activities may rely on a diminishing workforce whose skills they downplay in gendered and lay terms. This contradiction corresponds with long-held conclusions about the gendered, exploitative reputation of care work, a characterisation discursively constructed by privileging the moral dimensions of the job over the technical skills required for it. Significantly, the findings raise questions about the capacity of services, as they are currently structured and differentiated, to reshape and redefine aged care work as a 'good job', one that holds appeal and tangible rewards for new and younger skilled workers.

Nurturing spiritual well-being among older people in Australia: Drawing on Indigenous and non-Indigenous way of knowing.

AIM: The meaning of spiritual well-being as a health dimension is often contested and neglected in policy and practice. This paper explores spiritual well-being from both an Indigenous and a non-Indigenous perspective. METHOD: We drew on Indigenous and non-Indigenous methodologies to explore the existing knowledge around spiritual well-being and its relationship with health. RESULTS: The Indigenous perspective proposed that spiritual well-being is founded in The Dreaming, informs everyday relationships and can impact on health. The non-Indigenous perspective suggested that spiritual well-being is shaped by culture and religion, is of increased importance as one ages, and can improve coping and resilience stressors. CONCLUSIONS: Situating these perspectives side by side allows us to learn from both, and understand the importance of spirituality in people's lives. Further research is required to better address the spiritual well-being/health connection in policy and practice.

How do older Australian farming couples construct generativity across the life course?: A narrative exploration.

Australian farming, predominantly based on a family farming model, reflects a distinct culture and identity within Australia. Generativity can be identified within the longstanding practice of patrilineal generational farm succession. However, the changing social, economic and environmental context facing farmers today, is now threatening the sustainability and viability of the family farming model. The outcome in Australia, as elsewhere, has been a significant decline in the number of farming families and a sharp reduction in the number of young people entering farming. Overall, farmers are increasingly aging on farm in two-person households and without a next generation to follow. In this scenario, the article presents research which aims to explore how older Australian couples construct generativity across their life course. The study draws on constructionist narrative research conducted in the Australian New South Wales Southern Riverina. Generativity, as presented by Erikson (1950) and Kotre (1996), is utilised as a theoretical frame by which to explore the meaning of generational family farming in six couples' stories of navigating later life challenges. Drawing on Gubrium and Holstein's (1998) 'narrative practice' analytic framework, this article examines tensions between couples' jointly constructed narratives and the grand narrative of Australian family farming. A 'narrative practice' approach permits examination of the meaning of experience, coherence, and the ways contexts, as well as stories of the past influence stories told about couples' present and future generative expression. This approach is highly consistent with the rapidly changing farming context where couples may be trying hard to construct a coherent story within a distinct family farming grand narrative under considerable tension. Findings show that in this context, and often in the absence of the next generation, there are visible changes in farming couples' expression of generativity. The grand narrative of Australian family farming is compromised and older farming couples are being pressured to develop a new script for aging. In some cases, this is also causing significant tensions between couples, particularly around individual constructions of retirement. These findings may have some resonance with farming in other western countries, where aging farmers are faced with broad social and economic change.

Effective Community-Based Physical Activity Interventions for Older Adults Living in Rural and Regional Areas: A Systematic Review.

The purpose of this systematic review was to assess the characteristics and effectiveness of community-based interventions designed to increase physical activity participation in older adults (aged 65 years or more) living in rural or regional areas. Relevant peer-reviewed literature was obtained, using four primary electronic search engines, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses statement. The initial search identified 4,690 articles. After removal of duplicates and excluded articles, seven articles were included in the review. Few consistencies existed between intervention types, duration, outcome measures, and follow-up. Results provide some evidence to support the effectiveness of community-based interventions that include low- to moderate-intensity exercise to increase physical activity, physical function, and psychological state. However, without more rigorous studies it is difficult to identify the most critical characteristics of community-based interventions for older adults in rural and regional settings.

Moving towards integrated aged care assessment: A comparison of assessment tools across three regional Victorian services.

AIM: Recent National Aged Care Policy Reforms are directed at streamlining entry into aged care services, building on the challenges associated with developing integrated assessment processes. Such reform is core to achieving a comprehensive, efficient process. METHODS: Here, we report the first stage of a collaborative project with three regional aged care assessment services to explore how services can better work together and improve the assessment process. Specifically, this paper reports the collection of local demographic and assessment data to describe and compare assessment tools and processes across services. RESULTS: Findings demonstrate the high level of need of those entering the community aged care system; the diversity of tools and processes utilised by the three services; and the high level of duplication and commonality across assessment categories. CONCLUSIONS: Findings suggest the need for improved service integration to clarify the assessment process for older people and conserve regional aged care workforce.

Research protocol for a randomized controlled trial of the health effects of volunteering for seniors.

BACKGROUND: A growing evidence base demonstrates that interventions that focus on participation in physical and social activities can assist in preventing and treating both physical and mental health problems. In addition, there is some evidence that engaging in volunteering activities can provide beneficial social, physical, psychological, and cognitive outcomes for older people. This study will use a randomized controlled trial approach to investigate the potential for interventions involving volunteer activities to produce positive physical and psychological outcomes for older people, thereby contributing to the limited evidence relating to the potential for volunteering to provide multiple health effects. METHODS/DESIGN: This randomized controlled trial will involve 400 retired/non-employed individuals in good health aged 60+ years living in the metropolitan area in Perth, Western Australia. Participants will be recruited from the Perth metropolitan area using a variety of recruitment methods to achieve a diverse sample in terms of age, gender, and socioeconomic status. Consenting and eligible participants will be randomly assigned to an intervention (n = 200) or control group (n = 200). Those in the intervention group will be asked to engage in a minimum 60 min of volunteer activities per week for a period of 6 months, while those in the control group will be asked to maintain their existing lifestyle or take on new activities as they see fit. Physical and psychological outcomes will be assessed. Primary physical outcomes will include physical activity and sedentary time (measured using pedometers and Actigraph monitors) and physical health (measured using a battery of physical functioning tests, resting heart rate, blood pressure, BMI, and girth). Primary psychological outcomes will include psychological well-being, depression, self-esteem, and quality of life (measured using the Warwick-Edinburgh Mental Well-Being Scale, Center for Epidemiologic Studies Depression Scale, the Rosenberg Self-Esteem Survey, and the Global Quality of Life Scale, respectively). Secondary outcomes of interest will include attitudes to volunteering (measured via open-ended interviews) and personal growth, purpose in life, social support, and self-efficacy (measured using the Personal Growth and Purpose in Life subscales of Ryff's Psychological Well-Being Scale, the Social Provisions Scale, and the Generalized Self-Efficacy Scale, respectively). Participants will be re-assessed on these measures after 6 months. DISCUSSION: The results of this randomized controlled trial will generate new knowledge relating to the physical and psychological health benefits of different levels and types of volunteering for older people. In addition, insight will be provided into the major factors influencing the recruitment and retention of older volunteers. Understanding the full potential for volunteering to affect physical and mental well-being will provide policy makers with the evidence they require to determine appropriate investment in the volunteering sector, especially in relation to encouraging volunteering among older people who constitute an important resource for the community. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12615000091505. Date registered: 3 February, 2015.

Toward the Development of a More Integrated Aged Care Assessment Process for Rural Older Australians: Practitioners' Perspectives.

There is an identified need for more effective assessment processes in rural Australia, with prior research revealing little knowledge sharing and even duplication across existing services. This article aims to explore the challenges to more closely integrated assessment processes, drawing on interview data with practitioners from three agencies located in the same rural region. Findings highlight the challenges of rural assessment, both demand-driven (more older people with complex needs, geographic isolation) and supply issues (time and distance, funding formulae, workforce shortages). The need for closer collaboration is recognized but significant systemic issues require addressing if it is to be achieved.

Extrinsic and intrinsic factors impacting on the retention of older rural healthcare workers in the north Victorian public sector: a qualitative study.

INTRODUCTION: Workforce shortages in Australia's healthcare system, particularly across rural areas, are well documented. Future projections suggest that as the healthcare workforce ages and retires, there is an urgent need for strategies to retain older skilled employees. Very few qualitative studies, with theoretical underpinning, have focused on the retention of older rural nurses and allied healthcare workers. This study aimed to address these gaps in research knowledge. METHODS: This qualitative study is phase 2 of a large mixed-methods study to determine the factors that impact on the retention of older rural healthcare workers across northern Victoria, Australia. The initial phase, drawing on the effort-reward imbalance model found high levels of imbalance across a large sample of this population. The present study builds on these findings to explore in more depth the organisational (extrinsic) and individual/social (intrinsic) factors associated with retention. A purposeful stratified sample was drawn from participants at the survey phase (phase 1) and invited to take part in a semistructured telephone interview. A diverse group of 17 rural healthcare workers (nurses and allied health) aged 55 years or more, employed in the north Victorian public sector, were interviewed. The data were transcribed and later analysed thematically and inductively. RESULTS: Data were categorised into extrinsic and intrinsic factors that influenced their decisions to remain in their roles or leave employment. The main extrinsic factors included feeling valued by the organisation, workload pressures, feeling valued by clients, collegial support, work flexibility, and a lack of options. The main intrinsic factors included intention to retire, family influences, work enjoyment, financial influences, health, sense of self, and social input. Given the noted imbalance between (high) effort and (low) reward among participants overall, strategies were identified for improving this balance, and in turn, the retention of older rural healthcare workers. CONCLUSIONS: Study outcomes provide important insight into factors that impact on the retention of older rural healthcare workers, and, importantly, the imbalance in effort and reward participants experience in their current workplace. Use of a theoretical approach, and a two-stage methodology, enables a deeper understanding of these factors and the strategies needed to address them. Further research is now needed to test the effectiveness of these strategies in the older rural healthcare workforce.

Local governance responses to social inclusion for older rural Victorians: building resources, opportunities and capabilities.

AIM: To explore how local governance enables access to resources, creates opportunities and increases capability for older people in rural communities to experience social inclusion. METHOD: Twenty-six semi-structured interviews were undertaken with community stakeholders across two rural communities in north-east Victoria. Stakeholders were drawn from local government, and a range of community groups and organisations, as identified in a scoping study. RESULTS: Through the provision of community resources (e.g. physical and human infrastructure, organisational partnerships), local services and supports offer social and productive environments for participation. They also build individual resources (e.g. health, skills, finances, networks) to enable older people to participate within these environments, and provide assistance to allow older people to use individual and community resources. CONCLUSIONS: Community resources are integral in facilitating the development of older people's individual resources, and opportunities and capabilities for participation. These enable greater choice in participation, and contribute to the sustainability of community resources serving ageing populations.

Till death us do part? A critical analysis of obligation and choice for spousal caregivers.

Research demonstrates a significant number of carers identify obligation or lack of other alternatives as the reasons they undertake informal care. By utilizing critical discourse analysis, this research explores choice for informal caregivers in contemporary Australian social policy. Analysis demonstrates increasing shifts in policy toward choice in consumer-directed care, a feature absent for those who provide care. Familial care is a central pillar of Australian social policy, as it is in many liberal and conservative welfare regimes. Analysis reveals that these core social policies are fundamentally incongruent, with significant implications for individuals and social work practice.

Building social capital among rural, older Australians through information and communication technologies: a review article.

This paper undertakes a comprehensive review of the growing international literature on the adoption and use of information and communication technologies (ICTs) among older people. Issues associated with access and adoption of ICTs among older people living in rural communities will be explored, drawing on social capital as a theoretical lens through which to identify how these new technologies can build healthy ageing. ICTs as bridging social capital can address some of the challenges of service provision in rural Australia and provide access to more extensive information and resources. ICTs can also contribute to bonding social capital through access to other forms of communication to build on local connectedness. However, rural, older people face particular challenges of access, which may exacerbate the cycle of rural social exclusion. In the context of the Australian National Broadband rollout, it is timely to consider how some of these disparities can be addressed.

Volunteering and older women: psychosocial and health predictors of participation.

OBJECTIVES: As populations age, there will be a need for more volunteers in social welfare, and consequently a need to better understand potential effects of volunteering for older people. Whilst there is a body of international literature exploring health benefits of volunteering in later life, there are currently no longitudinal studies of Australian populations. Internationally, there is a lack of studies focusing on older women, who comprise the majority of the ageing population. The aim of this article was to explore the relationship between volunteering and psychosocial and health factors for a cohort of older Australian women over time. METHOD: Data for this study were from the oldest cohort of Australian Longitudinal Study on Women's Health, a 20-year longitudinal survey of Australian women aged 70-75 years in 1996. Volunteering status was the factor of interest and study factors included a broad range of demographic, health and social factors. A longitudinal model was developed for mediators of volunteering over time. RESULTS: Of 7088 women in 2005, 24.5% reported actively volunteering, 15.5% were continuing, 7.5% were new, 15.3% were intermittent and 34.7% had never been volunteers. Volunteering was associated with increased quality of life and social support. Women were more likely to continue volunteering over time if they lived in a rural area, had higher socioeconomic indicators, and better levels of physical and mental health. CONCLUSIONS: This study contributes to the literature on the relationship between volunteering and health for older women. Understanding the potential health implications of volunteering is a critical issue in current policy debates.