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Culture, Health and Aging: Global and Cross-Cultural Perspectives
Fall 1999
ANT 4930/6469 GEY 4935/6934 NRG 6931 PHC 6934 Professor Jay Sokolovsky Office: COQ 214 phone 553-1514 Office hours: TU, TH 11:00-12:00, WED 4-5:15; TH 9-10 OR BY APPOINTMENT e-mail jsokolov@bayflash.stpt.usf.edu |
This is truly the age of aging. We are on the leading edge
of a demographic and health revolution which will globally
reshape almost all aspects of life, such as perceptions of the
life cycle, the organization of health care systems;
intergenerational relations; the nature of family life; the
structure of communities and attitudes toward death.
This course will investigate health issues
related to aging
and cultural context in a world-wide sample of cultures. Special
topics to be considered include: the dimensions of a qualitative
gerontology; integrating qualitative methods into health and
aging research; the demographic revolution and the health
implications of population aging: the cultural context of health
and disability in late adulthood; cross-cultural and cross-
national perspectives on dementia; health problems and the self-
help movement; caregiving environments; social support networks
and community; gender, health and aging; ethnicity and long-term
care.
We will also attempt to apply the concerns
of
anthropological and qualitative research to the problems of aging
in our own society. This should always be a goal in the back
of
your mind when you are reading the assignments. You should come
to class prepared to discuss the readings. Class participation
will count toward your grade. The classes will run in seminar
fashion but will include a combination of lectures, discussion
and occasional audiovisual presentations. On the syllabus you
will find key questions to answer each week and I ACTUALLY EXPECT
YOU TO BE PREPARED TO DISCUSS THESE EACH WEEK!
WEB RESOURCES AND WEB LAB. Throughout the course you will be
reading materials from the web and have at least of our classes
in a computer lab. Throughout the class we will be using my web
site: "The Cultural Context of Aging" (CCA site) at:
www.stpt.usf.edu/~jsokolov.
Note: (1) When you begin readings in one of the six parts of book
3. you should explore my web site's "Resource Section" for that
part of the book. For example, the first two weeks of the course
you should look at the resources for the Introduction and Part I.
If you encounter problems in using the site or find resources
which you think would be helpful for students please bring these
to my attention. In fact there are a number of URLs which no
longer work;(2) The course outline will be on the web at
www.stpt.usf.edu/~jsokolov/syl4930.htm. You
should be able to
link to the web assignments on this page.
E-MAIL: I expect students to get an e-mail
account (they are
free through the computer center) and send me a message (my
address is on top of the first page) by the end of the second
week of the class - in the message tell me what you are thinking
of doing for your Health and Social Environment paper.
Grades will be based on the following:
Undergr Grad
Expert Panels Focus Paper (1): 15%
15%
Mid-term
25% 15%
Health & Environment paper.
25% 20%
Take Home Essay Final Exam: 25%
15%
Seminar Participation:
10% 10%
Term Paper or grant proposal:
25%
(for graduate students only)
NOTE ON RELIGIOUS OBSERVANCES: STUDENTS WHO
ANTICIPATE THE
NECESSITY OF BEING ABSENT FROM CLASS DUE TO THE OBSERVATION OF A
MAJOR RELIGIOUS OBSERVANCE MUST PROVIDE NOTES OF THE DATE(S) TO
THE INSTRUCTOR, IN WRITING, BY THE THIRD CLASS MEETING.
Required Readings:
1) Albert, S. and Maria Cattell. 1994. Old Age in Global
Perspective. New York: G.H. Hall
2) Sokolovsky, Jay, ed. 1997. The Cultural Context of Aging
2nd edition only.
3) Joel Savishinsky The Ends of Time: Life and Work in
a
Nursing Home. New York: Bergin and Garvey.
1991.
Note: In assignments below numbers, e.g. 1),
refer to the
texts above and JCCG refers to the Journal
of Cross-Cultural
Gerontology.
Aug 25: INTRODUCTION: AGING, HEALTH AND CULTURE
Sept. 1 INTRODUCTION: AGING, HEALTH AND CULTURE - TAKING
AN
INSIDE CULTURAL
VIEW.
1) Pp. 1-26 (up to "Aging, the Evolution of Human Longevity."
2) Sokolovsky: "Starting Points..."
Handout: "Shattering the Myths of Old Age."
Module on physical aging:
http://socrates.berkeley.edu/~aging/ModuleProcess.html
Special Resources:
Hurwicz, M.-L. ed. 1995. "Cultural Contexts of Aging and Health."
Special Issue of Medical Anthropology Quarterly.
9:2.
Focus questions
1) How can we apply the anthropological paradigm to
understanding health and frailty among the
TIWI - is it fair
to compare covering up to nursing home placement?
2) Which of the 6 myths of Old Age did you hold - why do
you
think that was the case?
3) What are most distinct elements of physical aging? How
does
culture influence this process?
9/8 LONGEVITY, CULTURE AND HEALTH
1) Finish Ch.2, 3
2) Part I, Pp. 1-6, Ch 1.
Handout P. Blanchette and V. Valcour, "Health and Aging Among
Baby Boomers, Generations Spring, 1998: 76-80.WEB LAB
SPECIAL NOTE: For the last hour of this class we will be in BAY225
in the computer lab making sure students have a feel of the web resources
we will be using for the semester. During the class we will get a start
on using some of the sites. At a minimum will will look at:
1. The Cultural Context of Aging web site: http://www.stpt.usf.edu/~jsokolov/
2. Longevity calculator http://www.beeson.org/Livingto100/quiz.htm
3. CENSUS BUREAU RESOURCES: (A) The International section of the US Census Bureau report "Gender and Aging: Mortality and Health," http://www.census.gov/ipc/www/publist.html [see publications under International Briefs, Populations Trends and Aging Trends]; and (B) Age Pyramid Calculator - http://www.census.gov/ftp/pub/ipc/www/idbpyr.html - select Italy, then at the bottom click on "Submit query." Repeat for China.
4. LINK TO GERONTOLOGY JOURNALS: http://www.camden.rutgers.edu/~wood/journals.html
Check out The Gerontologist.
5. Online Statistical Data on the Aging: General - http://www.aoa.gov/aoa/stats/statlink.html
- for international statistics http://www.aoa.dhhs.gov/NAIC/Notes/Internationalstats.html
7. PROJECT REACH: http://www.edc.gsph.pitt.edu/REACH/
8. STATE LONG-TERM CARE PROFILES:
http://www.aoa.dhhs.gov/aoa/hcbltc/profiles/
Web Assignment: N. Angier, "Theorists See Survival Value in
Menopause,
http://fig.cox.miami.edu/Faculty/Gaines/bil150/menopause.html
Web Project:
"The Living to 100 Life Expectancy Calculator," You put in health
information and learn about how changes in such factors can alter
their life expectancy. Project: Get your real life expectancy and
then alter the information, first to it higher and then to get it
lower. What are the main factors which bring it up or down?
[http://www.beeson.org/Livingto100/default.htm].
For Graduate Students: (1) In 1997, following a summit of eight
industrialized nations, a "white paper" was issued calling for a
shift in the perception of growing old from dependent to active
aging, [http://aspe.os.dhhs.gov/daltcp/reports/actaging.htm];
(2)
T. Perls, "The Oldest Old" by Tom Perls,
http://www.med.harvard.edu/programs/necs/sciamer195.html
Other Special Web Resources:
There are a number of ongoing longitudinal studies which are
tracking persons who live very long. One such project is The New
England Centenarian Study at Harvard Medical Center. Details of
this project, including some full-text articles can be found at,
[http://www.med.harvard.edu/programs/necs/].
The ElderWeb Sourcebook for Elder Care. This resource has some
excellent articles, such as one on health care costs - check out the
"library" at
[http://www.elderweb.com/].
Focus Issues:
1) What health issues are related to the world demographic
trend in population aging (Note the primary
differences
between the post-industrial societies ("developed)
and the
industrializing (developing)?
2) What are the demographic and epidemiologic transitions?
What
kinds of institutional and cultural changes
might these
transitions provoke?
3) How will aging of the baby boomer generation effect
health
issues related to seniors?
4) How might menopause be related to the evolution of longevity
among humans?
9/15 THE CULTURAL REVOLUTION AND THE HEALTH IMPLICATIONS OF
POPULATION AGING
1) Chap 4;
2) 5, Intro Part VI
Handouts: (1) M. Cattell, "Gender, Aging and Health: A
Comparative Approach." (2) T. Perls and R. Fretts, "Why Women
Live Longer Than Men."
Graduate Students, Web Assignments: The International section of
the US Census Bureau report "Gender and Aging: Mortality and
Health," http://www.census.gov/ipc/www/publist.html
[see
publications under International Briefs, Populations Trends and
Aging Trends; "International Evidence on Disability Trends Among
the Elderly," http://aspe.os.dhhs.gov/daltcp/reports/trends.htm
**Note: if you have problems getting this report, go to the home
page of the Office of Disability, Aging and Long-Term Care Policy
[http://aspe.os.dhhs.gov/daltcp/home.htm] and click the left menu saying
Newly Release Information and scroll down.
Graduate student resources: (library reserve): C. Longino, G.
Warheit and J. Green. "Class, Aging and Health;" Clark, D. and R.
Gibson "Race, Age, Chronic Disease and Disability, " in
Minorities, Aging and Health, 1997; Y. Beyene, "Cultural
Significance and Physiological Manifestations of Menopause: a
Biocultural Analysis"
Focus questions:
1) Why do women life longer than men? How is gender
an
important factor connection aging and health?
2) How might differences in culture effect the perception
of
the life cycle, especially late adulthood??
3) According to Project AGE, how is health related to
successful aging.
****SPECIAL NOTICE FOR STUDENTS!!! DUE TO THE WEEK LOST TO THE MYSTERY
STORM PLEASE FOLLOW THESE GUIDELINE.
1. YOU SHOULD BE HANDING IN YOUR 1ST PAPERS THIS WEEK - I WILL ALLOW
PEOPLE TO MAKE REVISIONS BASED ON THE DISCUSSION IN CLASS TO BE HANDED
IN NEXT WEEK.
2. FOR THE CLASS ON 9/22 WE WILL FOCUS ON THE FOLLOWING:
Why do women life longer than men? How is gender an important factor
connection aging and health?; According to Project AGE, how is health related
to successful aging; How does Niue culture deal with impaired elders and
explain their neglect? Be able to distinguish between impairment, disability
and handicap in relation to older adults - does culture play a
role here?
3. I have placed in bold the key readings for this class
9/22 STUDYING HEALTH, AGING AND DEPENDENCY IN CULTURAL CONTEXT
1) Ch. 9,
2) Ch. 21
Web Assignment: CCA, Part 6, Gerontological Anthropology in
Action, (1) S. Albert, "Anthropology and everyday competence,"
(2) Julie DaVanzo and David Adamson, "Russia's Demographic
"Crisis": How Real Is It?,"
http://www.rand.org/publications/IP/IP162/
Focus questions:
1) Be able to distinguish between impairment, disability
and
handicap in relation to older adults - does
culture play a
role here?
2) Why has male life expectancy in the Russia dropped over
the
past decade?
4) How do health and disease profiles in late life differ
in
countries like Russia, S. Korea and the U.S.
- What are some
implications for health care policy for older
adults?
FOCUS ON YOUR REPORTS - I WOULD LIKE SOME TO BE READ IN CLASS.
Due 9/22
Expert Panel Focus Papers : You are asked by the United Nations
Center on Aging in Vienna to use available data, to write a 3-4
page focus paper to be sent to key Schools of Public Health or
Health Ministries in Third World countries with relatively young
populations. In your report: 1) could you convince them to be
concerned about health and aging in countries such as Mexico,
Indonesia or India which are still demographically young?; 2) How
should the issue of disability in late life relate to #1; 3) Come
up with a brief plan of action for a specific country to attack
what you see as the most pressing problems related to the health
of the aged. [Note: feel free to speculate even if the data, for
a specific issue is not as complete as you would like]
3-4 PAGES DOUBLE SPACED -
Library Reserve Resources:
Goyal, R.S. 1997. "Implications for the Elderly of the
Demographic Transition: An Illustration from India," Bold 7:2:2-
10.
Kinsella, K. 1992. Population and Health Transitions, Washington,
D.C.: U.S. Bureau of the Census.
Aging Trends: Indonesia - A. Adlakha and D. Rudolph 9:1 1994
Aging Trends: Kenya - Kevin Kinsella
Dowd and Manton 1992. JCCG, 7:3: "Projections of Disability
Consequences in Indonesia"
SPECIAL NOTICE - YOU CAN HAND IN THE FOCUS PAPERS 9/29 WITHOUT PENALTY
9/29 GETTING IN DEEP - CULTURE, COMMUNITY AND HEALTH
Slides and video: "Families, Community and Elder Health in a
Mexican Indian Village."
. continue discussion of Ch. 9
2. 21, 9,
NOTE: Check out the suplementary materials on Ch. 9 at the CCA site:http://www.stpt.usf.edu/~jsokolov/part3.htm#supp
Web Assignment: CCA site, Resources, Part VI, Gerontological
Anthropology in Action, Counts, "Aging, Health, and Women in West
New Britain." http://arts.uwaterloo.ca/ANTHRO/WNB/AgingHealthandWomen.html
Graduate Students:
Reserve: Kaufman, "The Social Construction of Frailty," Journal
of Aging Studies 8:1:45-58, 1994.
Graduate student resource: The most important study in the US on
older women and disability was carried out in Baltimore and
reported on by Guralnik, J. et. al. 1995. The Woman's Health and
Aging Study: Health and Social Characteristics of Older Women
with Disability. [http://www.nih.gov/nia/edb/whasbook/title.htm].
Focus questions:
1. How does Niue culture deal with impaired elders and explain
their neglect?
2. How family and community support of the aged, especially the
frail aged in Amatango differ from the Island of Niue?
3. How has modernization affected the health of older women among
the Kaliai peoples of Papua New Guinea, and older women's role in
maintaining health in the community?
10/6 Working with Families and the Community to Combat Health
Problems
Slides: "The role of public health centers in promoting health
among the aged in Croatia"
1. Pp. 81-84; Ch 5, 6 (pay special attention to 128-38 on family
caregiving)
2. 2, 10
Web Assignment: CCA, Part 6, Gerontological Anthropology in
Action, Sokolovsky, Sosic and Pavlekovic. "Self-help
Hypertensive
Groups in
Yugoslavia: How Effective Are They?" Journal of Cross-
Cultural Gerontology, 6:3: 319-30, 1991.
Graduate Students: S. Tennstedt "Family Caregiving in an Aging
Society," [www.aoa.dhhs.gov/caregivers/FamCare.html];
"Geriatrics
and Elderly Care in Japan." Dr. Yasutomo Senoo, M.D., a doctor
working in a chronic care hospital, discusses the reality of
geriatric care in Japan, [http://www.st.rim.or.jp/~ysenoo/].
Recommended for graduate students:(1) Schoenberg, N. 1997. "A
Convergence of Health Beliefs: An 'Ethnography of Adherence' of
African-American Rural Elders with Hypertension. Human
Organization 56:2:174-81; (2) Hennessy, C.H. and R. John. 1995.
"The Interpretation of Burden among Pueblo Indian Caregivers."
Journal of Aging Studies 9(3):231-44. (3) Long, S. and P. Braudy-
Harris. "Caring for Bedridden Elderly: Ideals, Realities, and
Social Change in Japan." in Aging: Asian Experiences Past and
Present, S. Formanek and S. Linhart, eds. 1997.
Focus questions::
(1) Why did the public health system in Croatia feel it was
necessary to alter the way hypertension was
treated? What
are the key lessons learned from the study
of the self-help
groups?
(2) What does the "complaint discouse" of the Ju/'huoansi tell
us about their care of the frail elderly?
How is this
connected to the way their cultures looks
at aging and
treatment of impaired elders?
(3) Why are such a high percentage of the very frail elderly
in
Japan cared for by their daughters-in-law?
How Does Japanese
culture influence the nature of that care?
Does the web site
on Japanese geriatric care alter the discussion
in Brenda
Robb's article?
10/13 SOCIAL NETWORKS AND HEALTH AMONG THE ELDERLY:
***MIDTERM
EXAMS ARE DUE NEXT WEEK
Slides: "Health and Social Support Among the Poor Inner-city Aged
in New York"
2. Ch. 16, 17, (Box 4)
Handout. Jerrome, D. "Frailty and Friendship" JCCG 5:1:51-64,
1990.
Web Assignment, See, CCA site, Part 5, Gerontological
Anthropology in Action: Sokolovsky, J. and C. Cohen "Being
Old
in the Inner City:
Support Systems of the SRO Aged."in Dimensions
of an Anthropology of Aging, C. Fry (ed.). Praeger, 1981.
Graduate Students: Reserve: Cohen, C and J. Sokolovsky "Clinical
Use of Network Analysis for Psychiatric and Aged Populations,"
Community Mental Health Journal, 15 (3) :203-213, 1979
Graduate Student Resources: (1) Scharf, T. and C. Wenger. 1995.
International Perspectives on Community Care for Older People.
Aldershot: Avebury; (2) Wenger, C. 1992. "Support Networks and
Dementia: Aging in Liverpool." Working Paper 4, Bangor:
University of Wales, Centre for Social Policy Research and
Development; (3) Becker, G. 1993. "Continuity After a Stroke:
Implications of Life-Course Disruption in Old Age."
Gerontologist 33(2):148-58.
Web Resourse: Longitudinal Aging Study Amsterdam has conducted an important
study of Living Arrangements and Social Networks - read a report
at: http://www.scw.vu.nl/~tilburg/lsn_network_study.html
Focus Issues:
1) Why have social networks become so important in the
study of health and
aging? Why was this connection crucial
to Sokolovsky and Cohen's work in NYC SROs
2) According to Dorothy Jerrome (handout) and Yohko Tsuji
(Ch. 17), how are health issues, such as frailty, connected to variations
in friendship and other aspects of social networks?
3) How do the rural social networks Shenk talks about differ
from those Sokolovsky and Cohen studied in
New York? What
differences between Denmark and the U.S. best
account for
the variations in older women's social support
systems in
those two countries?
***MIDTERM EXAM. To be handed in next class.
MIDTERM: Answer 2 of the following 3 essay questions in about 2-3
double spaced typed pages each - BE SURE TO INTEGRATE SPECIFIC
STUDIES INTO YOUR ANSWER.
1) What are the most important ways culture impacts health
issues affecting the elderly?
2) The disablement process is an increasingly important
international issue for understanding late
adulthood.
How can cultural variation help us understand
the
distinction between, impairment, disability
and handicap.
3) Why has the study of variations is domestic settings
and
social networks become so important in studying
the support
of the elderly? What are the most important
factors
accounting for support as the elderly become
increasingly
frail?
10/20 GUEST LECTURE, JOAN BEZON - THE ELDER
HEALTH CLINIC IN
A TAMPA HOUSING COMPLEX.
Take-home
midterm due
Readings: Library Reserve: (1) Focus Group report on quality of
life among older residents in a Tampa housing project; (2) Damron-
Rodriguez, J., S. Wallace and R. Kington. "Service utilization
and Minority Elderly..." Gerontology and Geriatrics Education,
15(1):45-63, 1994.
Come prepared to discuss the focus group report: You are to read
the Focus Group report by a faculty at FMHI on the problems of
the elderly at an apartment complex in the Tampa area. Use the
other readings to frame an action plan to assist the Elder Care
Clinic - stressing how knowledge about ethnicity might be a
factor in what you propose. (Hint: you will have to write this up
as part of the final exam)
10/27 ETHNICITY, CONTEXT, AND HEALTH
Graduate students hand in 1 page outline for term project
2. Intro to Part IV, 12, 14, 13
Handout: (1) Yeo, G. "Ethnogeriatrics: Cross-Cultural Care of
Older Adults"
Web Assignment: Dilworth-Anderson, "The Structure and Outcomes of
Caregiving in Elderly Blacks,"
[http://www.isr.umich.edu/rcgd/prba/persp/sp97/structure.html].
Graduate Student Web Assignment: Martin, L. and B. Soldo. 1997.
Racial and Ethnic Differences in the Health of Older Americans,
(note at this site, select "open book," on left) [http://books.nap.edu/catalog/5237.html].
Resources for graduate students: Reserve: Hopper, S. 1993. "The
Influence of Ethnicity on the Health of Older Women." Clinics in
Geriatric Medicine: Care of the Older Woman 9:231-57.
Focus questions:
1) According to Gwen Yeo, what is ethnogeriatrics? How is
Dilworth-Anderson planning on using this approach to studying how
African American families respond to dementia (Web Assignment)?
2) Why is Sokolovsky pessimistic about ethnic families providing
all the support elderly require in American society? How is
gender important in this discussion?
3) How do the cases discussed in the Peterson and Yee articles
support or contradict the discussion in the Sokolovsky chapter?
11/3 CLASS ON THE CULTURAL CONTEXT OF FRAILTY AND END
OF
LIFE DECISIONS
- Where is Dr. Death When We Need Him?
Class Debate
on Assisted Suicide
1. 10
2. 3, 23
Handouts: (1) "Physician Assisted Suicide in The Netherlands"
Web Assignment: (1) "Suicide," [www.Trinity.edu/~mkearl/death-su.html].
(2) "Relinquishing Care." by Lisa Groger.
NOTE: read the 1st 4 "New Flashes" for "resources," Part I and check
out web site of Professor Nan Chico:
[www.isis.csuhayward.edu/ALSS/soc/NAN/dd/ddend.htm].
- See especially the links: HOW SHOULD WE DIE IN AMERICA? THE
VIEWS AND PRACTICES OF DOCTORS and INTERNATIONAL ANTI-EUTHANASIA TASK FORCE.
Web Assignment: Professor Lisa Groger has summitted a paper CARING TOO MUCH? CULTURAL LAG IN AFRICAN AMERICANS' PERCEPTIONS OF FILIAL RESPONSIBILITIES, for publication - read it by clicking on the title and let me know what are your questions and critiques of it.
Graduate Students Resource: Reserve, "'Rational Suicide on Grounds of Old Age."
Note: During this class we will debate the issue of whether
states should allow physician assisted suicide.
Focus Questions:
1) What are the key conclusions to be drawn from Lisa Groger's focus
group study of African American ideas about frailty and caregiving? Does
these conclusions connect with the discussion of disability in Ch. 23 in
book 2.
2) What are the basic results of Glascock's comparative study of "death hastening" behaviors toward the elderly and Albert and Cattell's discussion in Ch. 10?
3) Class debate on assisted suicide - should it be legal in the United States?.
11/10 THE ETHNO-CULTURAL
CONTEXT OF AGING AND HEALTH Guest Lecture: Neil Henderson: Dementia
and Ethnicity
1) PP. 199-202 ("Self-rated health..)
2) 22, 24
Reserve: S. Kunitz and J Levy. 1998. "Aging and Health Among
Navajo Indians,"
Handout: Yee and Weaver, "Ethnic Minorities and Health Promotion:
Developing a 'Culturally Competent' Agenda," Generations Spring
1994:39-44.
Graduate student resources:
Reserve, (1) Elliot, C., et al. 1996. "Working with Chinese
Families in the Context of Dementia" in Aging and the Dementias;
(2) Traphagan, J. 1998. "Localizing Senility: Illness and Agency
Among Older Japanese," JCCG 13:81-98.
Focus issues:
1) Can any of the lessons learned in the Sokolovsky et
al. work
in Croatia (10/6) help in understanding why
the support
groups Henderson studied in Tampa collapsed?
2) How does culture influence the perception, expression
and
response to dementia?
3) How does culture and context help us understand aging
and
health among Native Americans?
11/17 ALTERNATIVE ENVIRONMENTS FOR FRAIL ELDERS
Films: On Lok:
A Chinese Day Care Center; Swedish Care
for the Elderly
PROJECT II ASSESSMENT OF LIVING IN A
COMMUNITY ENVIRONMENT
DUE
2) 11,
Handouts: (1) J. Gubrium - "Welcome to the Real World" From The
mosaic of Care. (2) Reserve: Kane, R., L. Hixon Illston and N.
Miller. 1992. Qualitative Analysis of the Program of All-
Inclusive Care for the Elderly (PACE)," Gerontologist 32, No. 6,
Web Assignment: Florida's famous elder communities
- New Realities
Graduate student resources: Reserve, Reynolds, et al. 1999.
"Profile of Older Floridians," Tampa: Florida Policy Exchange
Center on Aging; Diamond, T. 1992. Making Gray Gold: Narratives
of Nursing Home Care. Chicago: University of Chicago Press.
11/24 The Last Hello: Late Life in Institutional Care
Video - Pet Therapy
3. chaps 1-4
Graduate Students: 2. 25
Web Activity: Mapping Long-Term Care. This site was developed
from a report on "State Long-term Care Profiles" and uses a map
of the United States to allow viewers to click on a state and get
a summary of 25 data tables for that state. Compare Florida to
one other state where the long term care variable are very
different. What are the implications of the differences for state
wide planning, [www.aoa.dhhs.gov/aoa/hcbltc/profiles/].
Web Assignment: Perelle and Granville "Assessment of the
Effectiveness of a Pet Facilitated Therapy Program in a Nursing
Home Setting," [www.psyeta.org/sa/sa1.1/perelle.html].
Graduate Student Resources: Henderson, N. "The Culture of Care in
a Nursing Home: Effects of a Medicalized Model of Long-Term
Care." from The Culture of Long-Term Care, Henderson and Vesperi,
eds, 1995; Doty, P. "International Long-Term Care Reform: A
Demographic, Economic, and Policy Overview" JCCG 8:447-61, 1993.
12/1 TAKE HOME FINAL GIVEN OUT (see below) - DUE BY 6PM DEC. 8 IN MY
MAILBOX
(258 DAVIS) OR IN THE ENVELOPE ON MY OFFICE
DOOR - 214 COQ.
YOU CAN ALSO E-MAIL IT TO ME.
Guest Lecture, Larry Polifka: "The Future
of Long-Term Care
in Florida."
GRADUATE STUDENTS: HAND IN TERM PAPER
Finish book :
Handout: Journal of Healthcare Design, "Long-term Care Design:
Cultural Expectations & Locale - Creating the Eldergarden." by Dr.
Thomas,
Web Assignment: [www.edenalt.com].
Explore Dr. William Thomas' mission to transform
every nursing home in America into a place resembling our common
understanding of a "real" home [www.edenalt.com].
Graduate Students: Haven, B., ed. 1996. "Long-Term Care in Five
Countries" Special Issue, Canadian Journal on Aging 16(1).
FINAL EXAM:
ANSWER BOTH OF THE FOLLOWING ESSAYS IN ABOUT 2-3 TYPED PAGES. DUE
DECEMBER 8 BY 6PM IN MY OFFICE OR E-MAILED. NOTE: READ BELOW THE
QUESTIONS TO SEE MY ANSWER TO A QUESTION A STUDENT HAD ABOUT THE ESSAYS.
NOTE: REMEMBER I EXPECT YOU TO INTEGRATE THE COURSE READINGS INTO
YOUR ESSAYS!!!!
1) Ethnicity is often discussed as an important issue to take
into account in gerontological research, however it is seldom
used as an important qualitative variable. (1) what are the most
important issues involved in using ethnicity as a qualitative
variable in gerontological research. (2) what are the most
important ways we can use ethnicity to understand health issues
in old age (hint: you might want to talk about social networks;
family support and gender).
2) How does the local culture created in traditional nursing
homes cause them to be such a feared setting in which to spend
any part of your elder years? What were the main findings of Joel
Savishinsky's book - especially in relation to the impact of pets
in such environments.
------------------------------------
Regarding your questions:
Qualitatative variable: for example in terms of our discussion of ethnic
elders and social networks, eg African American families - eg The role
of the elder in the household versus just noting their living with relatives;
the complexity of networks rather than just the number of people or frequency
of visits.
Local culture: refers to the internal social order created in particular
nursing homes - focus on issues like how pet therapy can alter this.
----------------------------
All Students must do the Expert panel paper and health and
environment interview paper.
APPENDIX A: Expert Panel Focus Paper - Due 9/22
You will be graded on one short focus papers
3-4 pages
maximum (double spaced and typed). You are to place yourself in
the role of a public health expert addressing specific questions
related to aging and health. The emphasis will be on getting
to
the point and making recommendations through the assessment of
available information. As an "expert" you will be expected to
determine if the data available is inadequate to make the
assessments requested and then suggest the types of information
future studies should address.
TOPIC You are asked by the United Nations Center on Aging in
Vienna to use the data in Population and Health Transitions, to
write a 3-4 page focus paper to be sent to key Schools of Public
Health or Health Ministries in Third World countries with
relatively young populations. In your report: 1) could you
convince them to be concerned about health and aging in countries
such as Mexico, Indonesia or Kenya which are still
demographically young?; 2) How should the issue of disability in
late life relate to #1; 3) Come up with a brief plan of action to
attack what you see as the most pressing problems related to the
health of the aged. [Note: feel free to speculate even if the
data, for a specific issue is not as complete as you would like]
3-4 PAGES DOUBLE SPACED -
PROJECT I HEALTH AND ENVIRONMENT - ASSESSMENT OF LIVING IN A
COMMUNITY ENVIRONMENT
DUE 11/17
The purpose of this assignment is to encourage you to have some
contact with elderly persons in order to assess the role that the
physical and social environment plays in conditioning his or her
life and perception of health in late adulthood. I would like
you to contact and arrange to interview a two persons (1 male and
1 female) over 65 years of age. It is not essential that you
already know this person well. However, you may find it easier
to talk with a relative, friend, or other old person with whom
you are already familiar. You should anticipate two interviews
per person of about an hour's length each, so that you can gain a
feel for some of the subtleties of your subject's lifestyle.
However, the length of the interview will vary considerably
according to individual circumstances. In talking with this
person I would like you to focus on two issues.
1. HOW MIGHT THEIR PHYSICAL AND SOCIAL ENVIRONMENT INFLUENCE
PERCEPTIONS OF HEALTH AND FUNCTION IN LATE LIFE?
You should attempt to obtain information on:
the nature of
the neighborhood (urban? rural? suburban?
small town?); the
characteristics of the person's residence
(small run-down
house? large apartment? mobile home?, etc.);
the
individual's living arrangements (alone? with
family? with a
live-in companion?, etc.); and any other features
of the
person's living situation and physical environment
(including interior of their residence) that
you consider
relevant; the kinds of people in the immediate
area. Use
your observational skills here. Be sure to
find out how long
the person has been in the current environment
and where
they last resided. Was the most related to
any changes in
physical status or health concerns or has
there been a
change since they moved there?
2. ARE THERE ANY ASPECTS OF THEIR CURRENT HEALTH CONDITION
WHICH THEY ATTRIBUTE TO AGING AND BEING AN OLDER ADULT? . When
and how did they first notice the health problems they relate to
aging. How have these health concerns affected how they interact
with their physical and social environment (e.g. limit things
they do or people or social groups they interact with)? What
kinds of adaptations has the person made to changes in their
health? (e.g. bought a hearing aid, installed safety devices in
their house, seen a doctor).
Note: it might be helpful to take them through
a typical day
during the last week.
In talking with the older person you should
try to identify
particular problems that may have emerged
as the individual
has grown older (for example, difficulty in
climbing stairs,
inability to walk to the store, unsteadiness
resulting in
the need to arrange furniture so that there
is always a
chair, table or other item to hold on to,
etc.. The intent
is for you to gain a feel for the degree to
which the older
person's physical environment is supportive
or provides
limitations on activity.
Paper: 3-5 page paper comparing and analyzing what you found. Are
there any implications of gender for how health impacts on their
interaction with their environment? Compare your results with any
relevant class materials - DUE /11/17
Graduate Students only: TERM PROJECT OPTIONS: APPENDIX B: Term
Paper or Grant Proposal: 12/1
1. Research Paper. As part of your grade you will be expected to
hand in a 12-15 page (double spaced - not including bibliography,
endnotes or appendix materials) paper on some topic related to
aging, culture and health. NOTE: you can connect this to the
Health and Environment project - that is an expanded version of
this work. The paper can involve either pure library research or
a combination of qualitative interviewing and observation
combined with library research. I would particularly encourage
students to think about doing a paper relevant to your current
work situation if this is part of your career plans. If you are
planning to do a paper involving original research it will be
important to start almost immediately and it is mandatory that
you discuss the project with me before starting. Two very
important books for those considering such a project are:
1) Gubrium, J. and A. Sankar (Eds.). 1994 Qualitative Methods
in Aging Research, Newbury, CA: Sage.
2) Fry, C. and Keith, J., New Methods for Old Age Research,
Bergin and Garvey, 1986.
2. Grant Proposal. In this option you will write a grant using
the forms for a specific agency, organization or foundation.
These can be found at the university sponsored research office.
First select a topic and then do some investigation as to which
organization has an interest in funding your research. In some
cases, you will find the forms on the web of the funding agency.
A good web site to use for exploring funding agencies is:
http://www.iupui.edu/~iucar/fundlinks.htm. On library reserve you
will find 2 grant proposals which were funded.
In terms of citation of references and bibliography
for
project 1., use the style found in your text - Old Age in Global
Perspective. For the grant proposal use the guidelines in the
instructions for preparing the grant.
Students who have done papers for related classes
may
continue working on the same topic from an expanded perspective
or different angle after showing me the paper.
Please note that to be able to help you with the papers I would
like you to hand in no later than 10/20, the paper title, a
paragraph description of the direction of your paper and the key
resources looked at to date. This should in no way inhibit you
from coming to see me to discuss the paper at any time.
DATE DUE: 12/1
Some General Topics for Papers:
Impact of Aids on minority elderly populations
Community Based Long-Term Care
Health Promotion - e.g. pharmaceutical versus holistic health
Self-Help Groups
Caregiver stress
Cultural Perception of Dementia
Homelessness/ housing
Social Support Systems
Ethnic perceptions of health and health seeking behaviors
Ethnic use/barriers to service use
Effectiveness of interventions
Gender and the informal care system
Elder Abuse