Caring for Our Elders

Caring for Our Elders: Multicultural Experiences With Nursing Home Placement

Patricia J. Kolb
Copyright Date: 2003
Pages: 208
https://www.jstor.org/stable/10.7312/kolb11458
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  • Book Info
    Caring for Our Elders
    Book Description:

    Almost forty percent of American adults age sixty-five and over spend some time in a nursing home, and residents in nursing homes will be increasingly diverse racially and ethnically because of changing demographics. The decision to place a family member in a nursing home is often extremely difficult, especially when the family belongs to a group with a strong tradition of filial responsibility. Despite these realities, little has been written about the stresses families of diverse cultural backgrounds experience in making this challenging decision.

    This book describes the experiences of seventy-five African American and Afro-Caribbean, white Jewish, and Latina/o residents and their relatives and friends who have been their caregivers. Integrating original qualitative research with quantitative data and theoretical perspectives and findings from other studies, Patricia Kolb not only presents new perspectives on how caregiving varies across racial and ethnic backgrounds but also dispels numerous stereotypes about nursing home placement among diverse groups.

    eISBN: 978-0-231-52902-0
    Subjects: Sociology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. ACKNOWLEDGMENTS
    (pp. ix-xii)
  4. INTRODUCTION
    (pp. 1-6)

    The number of people age sixty-five and over in the United States increased dramatically during the 1900s as life expectancy at birth rose from forty-seven years in 1900 to more than seventy years by the end of the century. Affecting each of us personally in our families and communities, a demographic explosion is taking place; the number of older adults will become larger and more diverse ethnically and racially in the twenty-first century. The number of people age sixty-five and over is projected to increase from about 34 million in the late 1990s to 80 million by 2050. The most...

  5. 1 THE NEED FOR NURSING HOME PLACEMENT
    (pp. 7-24)

    While some older people in the United States are able to live independently until the end of their lives, many, like the woman described above, eventually move to a nursing home. We need to understand all the factors, including contemporary social changes, that contribute to the need for nursing home placement. This chapter focuses primarily on two significant changes that are reflected in the decisions for placement made by many of the families in this study: extended life expectancy and employment outside of the home for greater numbers of women, who have traditionally been the primary caregivers.

    The twentieth century...

  6. 2 RESEARCH STUDIES ABOUT CAREGIVING BY FAMILY AND FRIENDS
    (pp. 25-45)

    This chapter will review research findings from studies about caregiving that are relevant to the experiences of the 75 residents of Acacia Nursing Home and their families who are the subjects of this study. Considerable research has focused on the relationship of the caregiver to the person receiving assistance, gender and caregiving, caregiving tasks, motivation for caregiving, and emotional responses to caregiving. This chapter also includes research in the less frequently studied areas of caregiving and ethnicity and race and nursing home placement. It is notable that in many caregiving studies the racial/ethnic background of the older adults and their...

  7. 3 EARLIER YEARS: LIFE WITHIN FAMILIES AND COMMUNITIES
    (pp. 46-68)

    This chapter is about the earlier adult lives of the Acacia residents, their lives before they developed the conditions that resulted in nursing home placement. It is about their relationships with relatives, friends, and other acquaintances in their communities. They knew neighbors in their apartment buildings; participated in religious organizations; developed relationships with coworkers; and were active in political organizations, voluntary organizations such as the Girl Scouts, and self-help organizations, including Alcoholics Anonymous.

    Life within their families was an important aspect of their earlier experiences, and the family relationships of some residents in each group were influenced by their migration...

  8. 4 CHANGING HEALTH, CHANGING RELATIONSHIPS
    (pp. 69-79)

    As life continued for the residents and their relatives and friends, all of the residents reached a time when they needed assistance because of changes in their physical and/or cognitive functioning. This chapter focuses upon the changes in those relationships when the resident had debilitating conditions that did not result in immediate placement but in the need for assistance with instrumental activities of daily living (IADLs) and/or activities of daily living (ADLs) at home. As indicated in chapter 2, IADLs include household chores, home repairs/maintenance, gardening/lawn care, errands, and transportation, and ADLs are personal care activities, including dressing, bathing, eating,...

  9. 5 THE PLACEMENT PROCESS: DECISIONS AND TRANSITIONS
    (pp. 80-103)

    This chapter begins with a description of issues regarding the health and living situations of the Acacia residents that resulted in the decision for nursing home placement. Discussion of the decision-making process follows, including comparison of the experiences of families in this study with those of families who participated in other studies that have addressed these same issues. Specific points explored here include the extent and nature of participation of relatives, residents, and social service and health care providers; emotional reactions of residents and relatives; and reasons for choosing this nursing home.

    The beginning of the transit stage of nursing...

  10. 6 SETTLING IN: ADJUSTING TO THE CHANGES
    (pp. 104-120)

    The experiences leading to admission had been difficult for residents and for their relatives and friends, but finally the day to move into the nursing home had arrived. This chapter addresses the final phase of the transit stage, admission day; the process of resettlement, or adjustment to life in the nursing home, including issues of ethnicity and provision of services; and reflections of relatives and friends about the placement decision and plans for the future.

    Adapting Drachman and Ryan’s stage-of-migration framework to the events taking place after admission, the discussion of the resettlement process for residents and their relatives and...

  11. 7 CONTINUING TO CARE FOR RELATIVES IN THE NURSING HOME
    (pp. 121-133)

    This chapter describes the caregiving tasks that relatives and friends had assumed since the residents’ admission to the nursing home, their motivations for caregiving, and their emotional responses to caregiving responsibilities. I shall also discuss the issue of who the informal caregivers are who have helped the resident the most and why changes in caregivers occurred.

    Consistent with Dobrof’s (1977) findings that in some families placement occurs because the family wants the best care and living situation for their relative, the relatives and friends in this study generally wanted the best for the residents and assumed responsibilities that would ensure...

  12. 8 WHO HELPS RESIDENTS AND THEIR RELATIVES?
    (pp. 134-170)

    In the previous chapters, this book has focused primarily on the experiences of the nursing home residents and their caregiving relatives and friends and has included much less information about the formal network of paid caregivers who provided a great deal of assistance before and after admission to Acacia Nursing Home. This chapter shifts attention to the paraprofessionals and professionals, reporting information about staff assistance that the relatives and friends considered “especially helpful,” structural impediments to nursing home service delivery, national workforce issues in nursing home care, alternatives to nursing home placement, and implications of this study’s findings for provision...

  13. REFERENCES
    (pp. 171-184)
  14. INDEX
    (pp. 185-192)