Older People In Israel Research Articles

Like one of the family? Understanding relationships between migrant live-in care workers and older care recipients in Israel

ABSTRACTFrail older people worldwide are increasingly being cared for in their own homes by migrant live-in care workers; however, extant literature on care relationships in this care context is sparse. The purpose of this mixed-methods study was to explore the quality and the nature of care relationships between full-time, live-in migrant care workers and older people in Israel. Quantitative and qualitative data were drawn from a 2014 survey of 116 migrant care workers and 73 older care recipients. Mean scores for four quantitative items relating to care relationships were examined and independent samplest-tests and Pearson correlations were performed, whereas qualitative data were examined using thematic analysis. Credibility of qualitative findings was checked by peer review. Most older people and migrant care workers gave high ratings to the four items. Significant correlations between the two groups were found for their responses on all four relationship items assessed, with only one item (‘get along well’) producing significantt-test differences. Qualitative data provided a deeper understanding of the quantitative ratings of care relationships. Four major qualitative themes emerged as inextricably tied with both groups’ perceptions of positive care relationships. These were: an emotional connection; reciprocity; effective communication; and meeting the older person's care needs. Study findings were interpreted through the theoretical lens of relationship-centred care. Implications of the findings for theory, practice and further research are discussed.

Exploring the characteristics of potential and current users of mobility scooters, among older people in Israel

Recognizing the decline in the ability of older people to serve as vehicle drivers and their physical limitations for long walks, mobility scooters are considered as an alternative mobility means for older people. An increasing popularity of scooters is recently being observed in Israel, raising safety concerns. This study explored the characteristics of potential users of mobility scooters among older people in Israel and the behaviours of their current users, by means of an opinion survey and field observations in urban areas. The opinion survey applied structured interviews, with 110 persons aged 65+. The survey's results showed that most people agreed that scooters may improve their mobility and quality of life. However, they expressed a relatively low willingness to use scooters, mostly, due to the preference for private cars but also the lack of appropriate infrastructure for safe scooter travel in the city. An increasing potential for scooters' use was associated with ages 70–84, people who are aware of their health problems and less involved in physical activities but still maintain an active lifestyle, living independently and appreciating scooter benefits. The observations included 55 video-records with older scooter riders. They showed that regardless the types of urban road or junction, the majority of scooter riders behaved like a vehicle, i.e. travelled on the roadway. Scooters' moving on a sidewalk did not create conflicts with pedestrians, while scooters travelling on the roads sometimes disturbed vehicle flows and created dangerous situations. To ensure safety of the scooter users, their travels on the sidewalks should be stimulated and, thus, appropriate adjustments of urban infrastructure are required.

Depression statuses and related predictors in later life: A 10-year follow-up study in Israel.

The aim of the current study was to investigate the factors associated with depression statuses in a 10-year follow-up of community-dwelling older adults in Israel. Longitudinal data were used from the Israeli sample of the Survey of Health, Aging and Retirement in Europe, assessing the depressive symptoms in 1042 respondents, aged 50 or above, at three time points: 2004/2005 (Wave I); 2009/2010 (Wave II); and 2014/2015 (Wave III). Multinomial logistic regression was used to determine the relationships among explanatory variables and depression statuses (no-depression, intermittent depression, or persistent depression). Some 46.5% of the participants suffered from intermittent or persistent depression. Five factors were associated with increasing the probability of both intermittent and persistent depression: being female, unemployed, less educated, physically disabled, and in poor health. Five other explanatory variables were associated only with a higher risk for persistent depression: low family income, widowhood, physical inactivity, more than two chronic diseases, and cognitive dysfunction. According to these findings, depression is common among older people in Israel. Low socio-economic status and poor subjective and physical health are significant determinants of depression statuses over time, underlining the importance of taking measures to improve these conditions in order to reduce the risk of depression in old age.

Quality of life of older people in Israel: a comparison between older people living at home who are members of a ‘supportive community’ and nursing home residents

The supportive community is a program that was developed in Israel for older people who live at home. The program provides its members with a service package that includes medical and social services, emergency call-button, cultural activities, and a ‘community parent’ who is responsible for the members. Using quantitative method, this study compared the level of quality of life between 55 older people living in their homes who are members of a supportive community (average age = 74.7) and 60 elderly people living in nursing homes (average age = 75.8). As expected, results indicate that quality of life among the older people living at their homes who are members of a supportive community was higher than among the older people living in a nursing home. In addition, the quality of life of married, educated, functionally independent older people in good health and with a good economic situation was higher. Predictor variables of quality of life were: the place of residence, health status, and age. In light of increased life expectancy and the growing need to care for the older population, the practical application of the study focused on a recommendation for the social services to continue the support community development program.

A German-Israeli Comparison of Informal and Formal Service Use Among Aged 75+

The paper focuses on filial norms and attitudes of older people about the care system of welfare states. It is a further investigation of the OASIS cross national study and examines three questions: First, what do older people in Israel and Germany consider to be the proper balance between the family and the welfare state regarding elder care? Second, what are the responsibilities of the family, the welfare state and other caregivers? Third, in what way do values, filial norms and personal resources relate to actual service use? The empirical data is based on information gathered from respondents living in Israel and Germany, aged 75+. The results of the study indicate that familial help has not been fully replaced by welfare state services. These findings support the complementary perspective. The results also show that most respondents favour a shared responsibility between the welfare state and the family. The findings indicate that familial norms are stable and strong as expressed by elders in both countries. The health situation is the main factor for receiving welfare services and familial help in Israel. In Germany the strong effect of living alone for receipt of welfare services underscores the influence of older adults' social and personal resources on actual service use. The article discusses the findings referring to the importance of a combined mix of the different sources of help for social policy implications.

The meaning of stigma: identity construction in two old-age institutions

People in advanced old age with frailties and those who are resident in old-age institutions manage their identities within the constraints of stigmatised settings. This paper compares the processes of identity construction in an old-age home and in a sheltered housing project for older people in Israel. Applying a symbolic-interactionist perspective that sees old-age institutions as social arenas for the reconstruction of identity, the paper first distinguishes the residents' constructions of stigma and deviance. While the old-age home residents collectively turned their stigma into a source of positive labelling, the sheltered housing residents drew advantages from their previous roles and statuses. Gossip is shown to play a critical role in reproducing stigma, particularly in the old-age home. These findings are used to demonstrate the variability and potential for adaptation among the residents – who are often stereotyped as homogeneous and passive. The paper concludes with a discussion of the literal and metaphorical languages used by older people, and of stigma as a positive instrument that can introduce content into the definition of the self.

Social networks, ethnicity and public home-care utilisation

This article examines the relationships between support networks, ethnicity and the utilisation of formal care services, taking into account background characteristics and functional health status among 3,403 older people in Israel. Data were drawn from a national survey in 1997 of people aged 60 or more years. The outcome variable was the use of publicly-financed personal care or homemaking services. About 15 per cent of the study population made use of such home care. Six informal support network constellations were identified by applying cluster analysis to key criterion variables that reflect the inter-personal milieu. The resultant network types were: community-clan, family-focused, diverse, friend-focused, neighbour-focused, and restricted networks. Binary logistic regression revealed that the use of formal home-care services was significantly associated with a respondent's age, gender, functional level and informal support network type (Nagelkerke R2=0.39). No association was found between home-care utilisation and a respondent's ethnicity (Arab, Jew, and new Russian immigrant), income or education. The results show that publicly-financed formal care services were utilised more frequently by older-old persons, women, functionally impaired individuals and people embedded in the neighbour-focused and restricted networks (and to a lesser degree, in the diverse and friend-focused networks). Neighbour-focused and restricted network types were characterised by fewer informal support resources at their disposal than the other types. Thus, formal home care was sought more often in cases in which the informal sources of support had less capacity to provide ongoing informal care.

Use and non-use of Automatic Teller Machines by older people in Israel

The final goal of the present research is to formulate a design concept for automatic teller machines (ATMs), to render them more accessible to older people. It should take into account all possible disabilities of users (cognitive, sensory, and motor problems), as well as subjective values, accessibility to technological devices, and need of specific services. Based upon a study by Rogers et al, the current study involved collection and analysis of data on usage and non-usage of ATM by elderly people in Israel (aged above 65) and a comparison to corresponding data collected in USA. It is focussed on studying the needs of the elderly users basic for future usability design requirements.

Assisted-living for older people in Israel: market control or government regulation?

In recent decades there has been a rapid expansion of assisted-living facilities for older people in many different countries. Much of this growth has occurred with only limited or no government regulation, but many problems have arisen, typically around the quality of care, which have led to demands that governments act to protect vulnerable residents. This paper examines whether formal legal regulation is the optimal policy to protect the needs and rights of frail residents, while respecting the legitimate interests of others, such as operators and owners. It presents the case for and against direct legal regulation (as in institutions), and suggests that no overall a priori assessment is possible. The analysis is based on the case of Israel, where proposed regulations for assisted-living have been introduced but not implemented. After a brief history of assisted-living in Israel – its recent dramatic growth and why this occurred – the paper concludes that formal direct regulation is not the best route to follow, but that the better course would be to develop totally new ‘combined’ regulatory legislation. This would define the rights of residents and encourage self-regulation alongside minimal and measured mechanisms of deterrence. Such an approach could promote the continued development of the assisted-living industry in Israel and elsewhere, while guaranteeing that the rights, needs and dignity of older residents are protected.