EDUCATION FOR THE ELDERLY: TRENDS AND PROBLEMS IN THE 1980s

The 1980s will see a trend toward lifelong education and a resulting shift in educational emphasis to educating older people. As part of this trend, more people will reach retirement in good health and with high educational levels. Therefore the elderly will become a more notable group of educational consumers in the decade to come. This paper identifies four groups of elderly educational consumers based on their interests and needs. Each group is delineated, and problems inherent in meeting their needs are discussed.     

Integrating expanded school mental health programs and school‐based health centers

This article provides background on national movements toward expanded school mental health (ESMH) programs and school‐based health centers (SBHCs), and presents advantages and challenges of joining these two systems of child and adolescent health care. Delivering ESMH through SBHCs promotes an interdisciplinary approach, health–mental health care integration, and benefits including enhancing referral bases, improving screening of problems, and enhanced confidentiality and privacy. But this integrated approach also presents challenges including managing referrals and significant needs, handling crises, building a focus on prevention and mental health promotion, handling administrative demands, and coping with limited resources. These challenges, ideas for overcoming them, and future directions for this promising service delivery approach are discussed. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 297–308, 2003.     

AGING AND DEVELOPMENTAL DISABILITIES: SERVICE PROVIDER HEALTH‐CARE TRAINING NEEDS

The numbers of aging and older persons with developmental disabilities are rapidly growing. Knowledge based on new and ongoing research is fast beginning to accumulate. Efforts to provide training, both preservice and in‐service, are beginning to be implemented. This article (a) reports on existing health‐care training materials, (b) discusses service providers’ training needs in the area of developmental disabilities and aging, and (c) provides recommendations for future training and curriculum development. The investigation included a search of library and archival records for existing information on health, aging, and developmental disabilities; semistructured interviews with 20 “expert” providers of health care to developmentally disabled elderly individuals; and a survey of 245 service providers for their perceptions of providers’ training needs in the area of health care for older adults with developmental disabilities.     

GERONTOLOGICAL KNOWLEDGE AND ELDERLY HEALTH CARE SERVICES IN ALASKA: AGING IN THE LAST FRONTIER

The current research assessed Alaskan health and mental health care professionals’ perceptions regarding Alaska's elderly health care services as well as professional educational and training needs. Fifty‐four percent of community professionals sampled indicated that preexisting services in their community were not adequate to meet the needs of the elderly population. In addition, 55% indicated that the knowledge level of community professionals regarding the elderly and the aging process was insufficient and 51% believed they were not well educated in meeting the needs of Alaskan native elders. An overall 91.8% indicted that they were in need of further training in the field of aging and geriatrics. They noted in particular the lack of knowledge and training opportunities in mental health and Alzheimer's disease. The significance of these findings is discussed in terms of the broader social implications associated with meeting gerontological and geriatric education and training needs, as well as the specific education and training problems of Alaskan health care professionals in keeping up with the recent trend of “aging in the last frontier.”     

GERONTOLOGICAL INTEREST AND OPINIONS OF HEALTH CARE PROVIDERS

The purpose of this study was (1) to examine and analyze the opinions and interests in geriatrics, gerontology, and older people of physicians, registered nurses, and dentists; and (2) to make comparisons of the expressed interests and opinions between the three groups of practitioners. The instrument consisted of two parts, demographic information and 22 questions regarding the interest and training in geriatrics/gerontology and opinions of the health needs of the elderly. From the results obtained in this study implications for the future training of health care providers are discussed.     

Participating in action research on a health promotion project: a reflection

A manager of the Out-Patient Department at Delancey Assessment and Rehabilitation Hospital, a semi-acute/acute unit specialising in assessment and rehabilitation for patients of all ages, attended a conference which led to the opportunity to participate in an action research project. Using a ‘tool’ devised by a team from South Bank University, it was hoped to monitorthe health promotion work done in the hospital and to demonstrate how this could be developed. The tool was used with groups of nurse students as a reflection aid during their Unit 3 (mental health/psychological needs) and Unit 4 (elderly care) placements. Using the tool gave structure to the sessions, enabling shortcomings to be highlighted and future plans to be formulated. It also demonstrated the way the students were starting to think about health promotion. Participation in the action research resulted in health promotion being introduced to a planned programme for students in clinical placements, which in turn increased their awareness and raised its profile throughout the hospital. The revised planned programme will be adapted for the longer placements now part of the student nurse curriculum and will include more practical experience of health promotion. Also, the implementation of training sessions for other grades of staff plus other disciplines will continue.     

我国农村社区居家养老研究综述：需求、供给与匹配

文章从养老需求、服务供给和供需匹配三个方面对2000—2019年间发表在CSSCI期刊(含扩展版)上的相关文献进行了梳理。发现养老需求方面的文献主要探讨了农村老人的需求结构、影响因素和特殊群体的养老需求;服务供给方面的文献主要探讨了供给主体和供给模式;供需匹配方面的文献主要探讨匹配程度的评价,提出了精准匹配的目标。从农村养老服务供求关系来看,未来研究的着力点应放在以下方面:一是识别农村老人有效需求,探讨社会因素对农村老人养老需求的影响及影响因素的动态变化;二是探索社会组织参与农村社区居家养老的激励机制、不同层级政府作用的实现机制和多元供给主体间的协同机制;三是加强对供需双方的信息共享机制以及"养老管家"和信息技术作用的研究。     

高职课程模式探究

加强高职课程研究,建立适应未来发展的高职课程体系,是当前高职教育改革的重点和难点。对我国高职课程模式进行反思,结合世界高职课程发展趋势,指出高职课程设置改革的理论支撑、价值取向、遵循原则以及改革的具体措施,提出高职课程设置要以满足社会经济发展和本专业发展需求为目标,课程内容以行业技能和素质拓展灵活设置,以确立适合我国高职的课程模式。     

完善上海居家高龄失能老人亲属照顾者的社会支持系统

亲属照护居家高龄失能老人仍是中国现阶段和今后较长时间内的主要照护形式。目前国内关于老年照护的研究集中于老年人本身的照护需求,而对亲属照顾者的照护状况、困难和需求研究不够深入。"高龄体弱老人照顾者需求和心理健康状况"课题组于2010年4—10月对上海市720名户籍城市居家高龄失能老人及其主要亲属照顾者所进行的抽样调查表明,目前上海居家高龄失能老人主要亲属照顾者的照护呈现女性居多、中老年退休者为主、经济条件适中、照护时间较长和照护责任心强的特点。照顾者在照顾过程中面对生理、心理和经济的压力虽然能够积极采取自我解压的方式,并从家庭获得支持,但同时对政府和社会提供支持也提出了迫切需求。为此,需要通过健全社会医疗保障体系,强化小区为基础的居家服务,加强照护知识技能培训,组建照顾者互助小组,完善以亲属照顾者需求为中心的社会支持系统。     

Supporting accomplished facilitation: examining the use of appreciative inquiry to inform the development of learning resources for medical educators

This paper examines the use of appreciative inquiry (AI) to guide development of web-based learning resources for medical educators who facilitate simulation-based learning experiences for doctors-in-training. AI can be viewed as a positive form of action research, which seeks to avoid deficit-based analyses and solutions, and commonly associated defensiveness. The use of AI to guide research and curriculum development has hitherto received scant attention.

Simulated medical practice allows learners’ needs to take top priority because simulated patients replace real patients (whose care would otherwise be top priority). Each episode of simulated clinical practice is followed by facilitated debriefing. Facilitators complete an initial ‘train the trainers’ course (typically one or three days). Our learning resources aimed to complement and extend initial courses.

AI informed data collection and analysis. It focused attention on identifying and understanding what was good about contemporary debriefing practices. We identified examples of practical wisdom and designed resources to help make these more transparent and accessible to all facilitators. Selected video records and interview excerpts demonstrated key points. We found opportunities to introduce ideas that would extend facilitators’ expertise.

We critique AI as an approach to action research and curriculum development, and recommend further use of AI in other contexts.     

Who Says there is No Life After Abandonment? A Grounded Theory on the Coping of Abandoned Filipino Elderly in Nursing Homes

Cases of abandoned elderly are increasing worldwide. By and large, this group struggles with the sudden change in living arrangement as well as abandonment by their families. Consequently, many elderly are forced into living in nursing homes for the remainder of their lives. Abandonment among these elderly negatively affects how they view themselves, which is detrimental to their health and well-being. Thus, exploring the feelings of elderly regarding their abandonment and how they cope becomes a major concern in caring for them. Recognizing the dearth of literature, this grounded theory study purported to describe sthe process by which these elderly cope with abandonment. A total of 24 abandoned Filipino elderly respondents were purposively selected to take part in a semistructured in-depth interview. Following the Glaserian approach, a four-part process emerged to describe the layer of human experience under study. The R.O.P.E. to Cope Theory of Abandonment describes how the elderly progress from the resisting, occupying, pondering, and embracing phases toward successful coping. Understanding this process equips health care providers with knowledge of appropriate interventions in the provision of holistic care to the elderly. Ultimately, findings of this study will be helpful in assisting abandoned elderly individuals in their path to achieving an improved quality of life and a happier perspective on it.     

The medical and psychosocial needs of children entering foster care

The estimated three to four hundred thousand children in foster care represent a population at high risk for medical and psychosocial problems. Their problems are compounded by the lack of adequate resources available to them while in foster care. This study provided a medical and psychosocial screening of 149 abused and neglected children entering the foster care system. The goal was to generate a profile of the medical and psychosocial needs of children entering the foster care system as a first step toward development of a better health care delivery system. Results indicated that these children have a much greater incidence of chronic medical conditions, are likely to weigh significantly less and be significantly shorter than the general population, require significant amounts of medical sub-specialty care, have a high incidence of developmental delays, and major deficits in adaptive behavior and have a large number of behavioral problems often associated with psychiatric disorders. Results are discussed in terms of the development of a regional model to effectively manage the health care needs of children entering foster care.     

TRAINING IN SUPPORT OF THE AMERICAN INDIAN ELDERCARE CAMPAIGN: REPLICATION OF AN AMERICAN INDIAN HOME‐CARE TRAINING PROGRAM

In 1991, the federal Administration on Aging initiated the National Eldercare Campaign to broaden the base of commitment and societal involvement to assist today's vulnerable elderly. With Administration on Aging funding, the project described in this study sought to enhance services to American Indian elders by training individuals as home‐care workers. The project replicated a previously developed American Indian paraprofessional home‐care worker curriculum at Fond du Lac Tribal and Community College in Cloquet, Minnesota. This program, which is transferable to Indian and non‐Indian communities, addressed three contemporary aging issues. First, it addressed the need to incorporate diversity and minority aging knowledge into the curriculum of postsecondary education. Second, it provided more accessible and better quality community‐based in‐home care to meet the needs of frail elderly. Third, this training program confronted the pervasive lack of employment opportunities in many American Indian and other minority communities.     

MOTIVATING STUDENTS IN THE HELPING PROFESSIONS TO WORK WITH THE AGED

Rationing is a concept newly introduced in health‐systems analysis in the United States. Although rationing, when applied to health care, is a fearful word to the elderly, at the most basic level it is simply a method that enables government to intervene in the private marketplace to allocate resources to achieve particular policy ends. This intervention to affect allocation of health care resources has long been used by all levels of government in the United States. Intervention by government in the private marketplace is examined as a means of expanding or limiting the supply of health care services or expanding or limiting the demand for such services. The Oregon rationing experiment with Medicaid services has significantly contributed to the introduction of the concept of rationing of health care. As expected, there is a disproportionate interest by the elderly in rationing health care; thus the effect of the Oregon rationing experiment on the elderly is discussed, as are other allocation interventions on long‐term care, as a service of particular interest to the elderly.     

Rationing and the long-term-care system

Rationing is a concept newly introduced in health-systems analysis in the United States. Although rationing, when applied to health care, is a fearful word to the elderly, at the most basic level it is simply a method that enables government to intervene in the private marketplace to allocate resources to achieve particular policy ends. This intervention to affect allocation of health care resources has long been used by all levels of government in the United States. Intervention by government in the private marketplace is examined as a means of expanding or limiting the supply of health care services or expanding or limiting the demand for such services. The Oregon rationing experiment with Medicaid services has significantly contributed to the introduction of the concept of rationing of health care. As expected, there is a disproportionate interest by the elderly in rationing health care; thus the effect of the Oregon rationing experiment on the elderly is discussed, as are other allocation interventions on long-term care, as a service of particular interest to the elderly.     

DEVELOPING AND USING INTERDISCIPLINARY CASE STUDIES IN TEACHING GERIATRICS TO PRACTICING HEALTH CARE PROFESSIONALS

Continuing education programs for health care professionals who practice in geriatrics are an important part of improving the health care provided to older adults. Programs utilizing active forms of learning that mimic the clinical environment are more successful at changing the behavior of health care professionals than traditional didactic styles of teaching. Problem-based learning methods allow learners to identify their own areas of strength and weakness and to work toward improvement in a manner best suited to their needs. This article describes an interdisciplinary team of educator-clinicians in geriatrics who developed clinical case studies embodying these approaches as one method of improving the learning process for adult health care providers. An actual sample case study is presented as an illustration of the principles embodied in this process. Lessons learned from the development and use of these case studies are summarized in the context of improving the quality of continuing education programs for health care professionals in geriatric practice.     

A Preliminary Investigation of the Use of Videophone Technology as a Training Tool for Students Working with Older Adults

Abstract

The purpose of this study was to examine changes in student's attitudes toward the use of low-cost videophone equipment as a tool for interacting with elderly residents. Students enrolled in four undergraduate social work courses were asked to observe and participate in a social history interview with a resident volunteer from an assisted-living facility located in north Mississippi. In order to measure changes in participants' attitudes toward technology, students completed the Student Telecommunication Satisfaction Questionnaire prior to and immediately after observing the interview. It was hypothesized that students would demonstrate a positive increase in their attitude toward the use of technology to deliver health care services after being exposed to such technology. The results of this study provide partial support for the hypothesis. In general, students responded positively to the use of video phone technology as a means of augmenting more traditional forms of communication.     

Integrative Public Health-Aligned Physical Education and Implications for the Professional Preparation of Future Teachers and Teacher Educators/Researchers in the Field

ABSTRACT

This article has two purposes: (a) to consider existing platforms and future possibilities in the United States for what the authors refer to as Integrative Public Health-Aligned Physical Education (IPHPE), which integrates standards-based K–12 physical education with a public health agenda focusing on promoting increased physical activity and fitness, and (b) to consider the implications of IPHPE for the preparation of future physical education teachers and teacher educators/researchers. First, the historical context that has nurtured the development of ideologies that inform IPHPE is summarized. Second, examples of these ideologies in terms of their current and prospective contributions to IPHPE perspectives are discussed. Third, building from existing public health-aligned recommendations for pre-service physical education teacher education (PETE) programs, IPHPE-based professional preparation requirements for future physical education teachers are considered. Finally, the focus shifts to doctoral PETE (D-PETE) programming and professional preparation requirements for future physical education teacher educators/researchers from an IPHPE perspective. The overall intention of this article is to propose a way forward for physical education which bridges educational priorities of the profession to contemporary and relevant public health needs.     

基于分形理论的山区村镇体系研究——以大别山区南溪镇为例

当前乡村聚落正面临转型和空间重构,村镇体系已经成为亟待研究的重要命题。本文基于分形的相关理论和方法,以皖西南溪镇为实证区域,对大别山区村镇体系的空间特征进行了探讨。结果表明：（1）南溪的村镇体系结构一定程度上服从Zipf定律,村镇体系规模结构有待进一步优化调整。（2）无标度区范围跨度狭窄,村镇体系的分形发育不完善,其空间分布既非高度集中也非均匀分布,呈现出中间状态。（3）山区村镇的职业结构分化显著。从业人口中,职业结构分化显著,这将有利于山区城镇化的推进和村镇体系的空间优化,而非从业人口基本是老人和留守儿童,在今后的山区居民点调整中应给予充分关注。     

健康中国背景下康养产业发展的问题与对策——以温州市洞头区为例

21世纪新兴的康养产业仍存在社会认识不足、跨界融合不深、同质发展严重等问题。温州市洞头区具备发展康养产业良好的环境、区位、社会条件,在产业领域、发展要素、制度建设等方面已进行了积极探索,构建了"1+2+N"康养产业体系,强化以项目为主体的载体支撑,加快以健康品牌为核心的形象树立,强化以深化改革为先导的制度创新,塑造以康养理念为重点的健康文化。其具体规划和措施对其他地区在健康中国背景下促进康养产业更好发展具有借鉴价值。