Department of Social Work, Jönköping University, Jönköping, Sweden.
Int J Older People Nurs. 2019 Jun;14(2):e12232. doi: 10.1111/opn.12232. Epub 2019 Mar 12.
Few empirical studies have examined strengths and support of older people in circumstances of precarity. A better understanding of this problem has the potential to contribute to the development of care planning and delivery.
To investigate how older people deal with episodes of precarity in South Louisiana.
More than 300 hr of participant observation and interviews were conducted with 20 predominantly older African American women in a housing complex for low-income older persons and two senior citizen centres.
The findings demonstrate five central negative conditions of precarity that older people had to manage: (a) loss and discontinuity of home-based healthcare services, (b) stress after loss or disruption of social support, (c) problems of poverty, (d) cognitive impairment and declining health and (e) stress of eviction. Strengths and support that older people used were as follows: (a) spiritual faith, (b) psychological strengths, (c) spiritual relationships, (d) family support, (e) friendships of love and friendships of helpfulness, (f) care and support performed by home-based services, (g) senior centre and housing complex activities, (h) church memberships and activities, and (i) grocery store and café contacts.
Home-based services were not sufficient to prevent and reduce precarity for older people because of a lack of and discontinuities in these services.
This study adds to the literature about precarity among community-based older people by demonstrating gaps in care support and medication access. The findings suggest that ongoing state funding and support by home-based services are necessary to support frail older people in precarious living conditions to survive and handle stressful life events by reducing vulnerability and enhancing strengths and supportive resources of older people.
很少有实证研究考察过弱势老年人在不稳定环境中的优势和支持。更好地了解这一问题有可能有助于制定护理计划和提供护理。
调查路易斯安那州南部的老年人如何应对不稳定情况。
对一个低收入老年人住房综合体和两个老年人中心的 20 名主要是老年非裔美国妇女进行了 300 多个小时的参与式观察和访谈。
研究结果表明，老年人必须应对五种不稳定的核心负面情况：(a)家庭医疗服务的丧失和中断；(b)社会支持丧失或中断后的压力；(c)贫困问题；(d)认知障碍和健康状况下降；(e)驱逐的压力。老年人利用的优势和支持如下：(a)精神信仰；(b)心理力量；(c)精神关系；(d)家庭支持；(e)爱情友谊和有益友谊；(f)家庭服务提供的护理和支持；(g)老年人中心和住房综合体活动；(h)教会成员资格和活动；以及(i)杂货店和咖啡馆的联系。
由于家庭服务的缺乏和不连续，这些服务不足以预防和减少老年人的脆弱性。
本研究通过展示护理支持和药物获取方面的差距，为社区老年人脆弱性方面的文献增添了内容。研究结果表明，需要持续的州政府资金和家庭服务支持，以支持脆弱的老年人在不稳定的生活条件下生存，并通过减少脆弱性和增强老年人的优势和支持资源来应对生活压力事件。
