Much of the literature concerning women with disabilities and aging relate to health care, and a good deal of that information pertains to women with intellectual disabilities. Other articles of interest include such topics as visual impairments, mental illnesses, chronic illnesses such as breast cancer and arthritis, an article on women with “child onset” disabilities aging from a nursing perspective, as well as articles on the “common ground” between gerontology, women with disabilities, and women in general, an article on late-life empowerment theory and dealing with the aging body, using a social work and feminist gerontology focus, an article on the ethical issues of women aging as an ongoing process, rather than focusing solely on “elderly” women, issues of caregiving and others.
Allen, J. (1993). Caring work and gender equity in an aging society. In J. Allen, & A. Pifer (Eds.), Women on the front lines: Meeting the challenges of an aging America. Washington, DC: The Urban Institute Press.
The author discusses how different aspects of the demand for care for elderly people might promote or hinder the integration of family care with paid employment and of caring work between men and women. Allen argues that without significant policy changes, the growing number of elderly people who need care will place an additional burden on women, who do the majority of the caring work. These women may have to sacrifice job earnings and health insurance, among other things, in order to care for elderly family members. The author outlines two proposed reforms in terms of gender equity issues, expanding paid home care, and creating government mandates for job leaves for family care.
Anderson, D. J. (2002, July-August). Health, age, and gender: How do women with intellectual disabilities fare? In M. P. Janicki & P. McCallion (Eds.), Aging people with intellectual disabilities: Dealing with the challenges of older age, Part II [Special issue]. Journal of Gerontological Social Work, 38(1/2), 137-160.
The 1994-1995 Disability Supplement to the National Health Interview Survey (administered to a representative sample of the U.S. population) was analyzed for women age 30 and older with intellectual disabilities (ID), developmental disabilities (DD) or both, in order to describe their functioning as they aged in the community. Definitions of ID and DD consistent with professional and legal standards were developed and adapted to the NHIS-D questions. An estimated .56% of the approximately 77 million civilian, noninstitutionalized, women age 30 and older in the United States have one of these disabilities. Compared with women in general, women with these disabilities had negative perceptions of their health status, particularly women with DD and health indicators tended to support their perceptions. Most were independent in activities of daily living (ADL), but instrumental activities of daily living (IADLs) posed more of a challenge, and limitations in major activities were common as was a high rate of distress and psychosocial difficulties. The findings suggest that the needs of these women are multiple in nature, involving economic resources, psychological support, possibly work assistance (e.g., job placement), education, social and family supports, in addition to rehabilitative supports more directly linked to specific disabilities.
Aronson, J. (2000, Fall). Missing voices in long-term care policy making: Elderly women and women with disabilities receiving home care. Centres for Excellence in Women’s Health Research Bulletin, 1(1), 14-15. Ottawa, Ontario: Centres of Excellence for Women’s Health Program and Research, Women’s Health Bureau. Retrieved March 18, 2005 from http://www.cewh-cesf.ca/bulletin/v1n1/page9.html
“This study explores the perspectives and aspirations of frail elderly women and younger women with disabilities who rely on care and assistance at home in Ontario. Their voices and their knowledge of the home care system are seldom included in current debates about long-term care policies that are, rather, dominated by the economically-driven imperatives of governments to manage efficiently and offload costs from the public ledger.”
This story is in the inaugural issue of the Centres of Excellence’s newsletter, focusing on a range of issues on women’s health. A full copy of the bulletin can be found at http://www.cewh-cesf.ca/bulletin/v1n1/CWH_english.pdf
Barlow, J. H., & Williams, B. (1999, January). ‘I now feel that I’m not just a bit of left luggage’: The experiences of older women with arthritis attending a personal independence course. Disability & Society, 14(1), 53-64.
Few interventions have directly addressed the needs of older people with arthritis. One exception is a recent initiative developed by Arthritis Care, a voluntary organisation working with and for people with arthritis in the UK. The initiative comprised two Phases. In Phase 1, older people attended a well established course designed to increase participants’ sense of control over their own ability to orchestrate the management of their arthritis-related needs. The focus of this paper is on Phase 2 of the initiative, a Personal Independence Course, which introduced older people to the social model of disability and encouraged them to take an active role in the community. Although Arthritis Care have considerable experience of working within a social model framework with younger people, this paper presents the results of the first Personal Independence Course targeting older adults with arthritis. Data were collected in a series of semi-structured interviews yielding rich insight into the lives of this often neglected group of older people.
Bedini, L. A., & Guinan, D. M. (1995, October). Motherhood revisited?: Recurring roles of family caregivers and their relationship to leisure. Paper presented at The 1995 Leisure Research Symposium, San Antonio, TX.
Research about understanding the leisure of women, particularly those in unique family and social roles such as mothers or single parents, is growing. Women who pursue the less defined roles of informal (unpaid) family caregivers for older adult members, however, are an under-researched group…. The purpose of this study was to examine the leisure of women who are informal family caregivers for older adult members from a life span/life stage perspective. Specifically, the responsibilities inherent in caregiving for an older family member were addressed regarding the concept of recurring roles and their impact on leisure.
Boyd, C. M., Xue, Q., Simpson, C. F., Guralinik, J. M., & Fried, L. P. (2005, November). Frailty, hospitalization, and progression of disability in a cohort of disabled older women. The American Journal of Medicine, 118(11), 1225-1231.
Purpose: To determine the association between a previously validated frailty phenotype and the development of new-onset dependence in activities of daily living, independent of hospitalizations and other established predictors of disability. Subjects: Seven hundred and forty-nine women enrolled in the Women’s Health and Aging Study-I who were independent in all activities in daily living when enrolled in the cohort.
Methods: Assessments and interviews were conducted through home visits at 6-month intervals for 3 years. Frailty was classified using a validated phenotype (>/=3 of the following: weight loss, exhaustion, slow walking, sedentariness, and weak grip), and hospitalizations were identified by self-report. Grouped-time proportional hazard models assessed associations among frailty, hospitalization, and the development of dependence in activities in daily living, adjusting for other factors.
Results: Twenty-five percent of the cohort (186/749) were frail at baseline; 56% (104/186) of frail versus 20% (23/117) of nonfrail women developed dependence in activities in daily living (P <.001). In multivariate analysis, frailty was independently associated with the development of dependence in activities in daily living (hazard ratio [HR] = 2.2; 95% confidence interval [CI]: 1.4 to 3.6), adjusting for hospitalization status, age, race, education, baseline functional status, cognition, depressive symptoms, number of chronic diseases, and self-reported health status. Additionally, a dose-response relationship existed between the number of frailty criteria that a woman had and the hazard of subsequent dependence in activities in daily living.
Conclusion: Frailty, conceptualized as an underlying vulnerability, and hospitalization, which marks an acute deterioration in health, were strongly and independently associated with new-onset dependence in activities in daily living. Additional research is needed to determine if dependence can be minimized by targeting resources and programs to frail older persons.
Brown, A. A., & Gill, C. J. (2002). Women with developmental disabilities: Health and aging. Current Women’s Health Reports, 2, 219-225. Retrieved March 13, 2005 from http://www.biomedcentral.com/content/pdf/cr-wr2334.pdf
Major shifts have occurred in the world of disability that have profound implications for health-service provision. Although health researchers and clinicians have begun to address the health needs of women with disabilities, representation of older women with intellectual disabilities in health research and health-care practice remains inadequate. As the visibility of this group continues to grow through policies that support greater community integration and longevity, they and their families, professionals, and advocates will require more information about their health concerns, and appropriate health services and options. This article provides an overview of major issues of women with developmental disabilities within the areas of primary health care, aging, access to health services, and future directions in research and practice.
Brown, A. A., & Murphy, L. (1999, June). Aging with developmental disabilities: Women’s health issues. Arlington, TX & Chicago, IL: The Arc of the United States and Rehabilitation Research and Training Center on Aging with Mental Retardation. Retrieved March 13, 2005 from http://www.uic.edu/orgs/rrtcamr/
“People with mental retardation and developmental disabilities are living longer, and good health plays a vital role in their quality of life as they age. Women generally live longer than men, so a larger number of growing population of older people with developmental disabilities will be women. More research is needed to understand all the specific health issues of aging women with developmental disabilities and ways to support a healthier life-style.”
A plain text/HTML version of this document can be found at: http://www.thearc.org/faqs/whealth.html
Burke, M., & Flaherty, S. M. J. (1993, January). Coping strategies and health status of elderly arthritic women. Journal of Advanced Nursing, 18(1), 7-13.
With increasing age many elderly people experience personal and social losses. Physical health declines, there is a loss of vigour and an increased susceptibility to disease. Osteoarthritis, the most common form of arthritis in the elderly, is the greatest cause of disability and limitation of activity in older populations. The purpose of this descriptive study was to investigate how elderly women cope with the physical impairment and pain associated with osteoarthritis and to examine the relationship between coping strategies and health status. The sample consisted of 130 women over 75 years, living alone in one of five life care communities. Three instruments were used to collect data: The Ways of Coping Scale, The Arthritis Impact Measurement Scale and The Musculoskeletal Impairment Index. Pearson product-moment correlations and stepwise multiple regression were used to analyse data. The mean age of the sample was 83.2 years and over 40% had attained bachelor’s degree or higher. The most utilized coping strategy was self-control. The study variables accounted for 49% of the variance in physical health and 20% in psychosocial health.
Burr, J. A., Mutchler, J. E., & Warren, J. P. (2005). State commitment to home and community-based services: Effects on independent living for older unmarried women. Journal of Aging & Social Policy, 17(1), 1-18.
This study examines the impact of state variation in commitment to the provision of home and community-based services on the living arrangement outcomes of older unmarried females with functional limitations. We combine data from the 1990 U.S. Census of Population (PUMS) with state-level information on long-term care home and community based service expenditures, nursing home bed availability, and Medicaid nursing home costs from a special report that compares state variation in long-term care systems. Using multilevel logistic regression modeling techniques, we find that the risk of institutionalization compared to community living arrangements is reduced as spending for home and community-based services at the state level increases. We discuss these findings in light of policy changes during the 1990s.
Canrinus, M., & Lunsky, Y. (2003). Successful aging of women with intellectual disabilities: The Toronto experience. Journal on Developmental Disabilities, 10(1), 73-78. Retrieved March 13, 2005 from http://www.oadd.org/publications/journal/
Older women with intellectual disabilities are a growing population, whose perspective has been traditionally ignored in research. This study aims to identify some key issues in aging for this group from the perspective of the women themselves. Nine women in the Greater Toronto Area participated in 1 to 2 hour interviews addressing personal demographics, economic and personal safety net, health, social roles, and well being. Findings indicate that these women face significant challenges as they age, especially in the areas of health and economic well being. Despite their challenging situations, most women report feeling relatively happy and are satisfied with the support in their lives.
Crooks, D. L. (2001, January-February). Older women with breast cancer: New understandings through grounded theory research. Health Care for Women International, 22(1-2), 99-114.
Breast cancer incidence increases by decade of life, significantly affecting the lives and well-being of older women. In a critical analysis of three decades of quantitative and qualitative research literature. I found an indication that something changed over the course of time that allowed women to adjust to breast cancer and resolve emotional turmoil. However, it was not clear what was “adjusted,” or what constituted the process that allowed women to restore meaning within illness. In this paper I discuss the benefits of using a grounded theory approach in the study of older women with breast cancer. A brief overview of the study is given for context. The main focus of this paper is on the contributions of grounded theory research to new understandings of the cancer experience for older women. Contrary to findings in the quantitative literature, this study raised awareness of several issues: the myth of burden in researching older women, willingness to participate in decision making around treatment, ageism, and positive collusion in communication with health professionals.
Davies, N., & Duff, M. (2001, June). Breast cancer screening for older women with intellectual disability living in community group homes. Journal of Intellectual Disability Research, 45(3), 253-257.
Breast cancer is one of the commonest cancers to affect women. Present health service guidelines call for screening and mammography for all women aged between 50 and 65 years in an effort to increase early detection and improve survival rates. Nulliparity is one of the associated risk factors for breast cancer. Women with intellectual disability (ID) are increasing in longevity and are frequently nulliparous, and therefore, they are at increased risk of developing breast cancer. The aim of the present study was to review the uptake and knowledge of women with ID living in the community of breast screening programmes. A postal survey of women aged 50 years with ID living in community group homes was used to gather data. Only one-third of the women carried out regular breast examination and a similar proportion had received invitations to mammography. General practitioners and practice nurses were currently playing very minor roles in breast screening these women. Primary health care professionals may be missing opportunistic health promotion opportunities and the support services for women with ID living in the community could be provided with better training and resources to improve breast cancer screening in this vulnerable group.
Davis, J. A. (2005). Differences in the health care needs and service utilization of women in nursing homes: Comparison by race/ethnicity. Journal of Women & Aging, 17(3), 57-71.
The purpose of this study is to describe health care needs and service utilization among institutionalized women of color. The sample was dichotomized by length of stay to determine how African American, Native American, Asian/Pacific Islander, and Hispanic/Latino women differed at two points in time. Data for this study came from the Current Resident Survey of the 1999 National Nursing Home Survey. The data were analyzed using GLM. The findings suggest that Native American women are the most impaired and Asian/Pacific Islander women are the least impaired. Additionally, very few women received mental health services despite their extensive need.
Dew, A., Llewellyn, G., & Gorman, J. (2006, November-December). “Having the time of my life”: An exploratory study of women with intellectual disability growing older. Health Care for Women International, 27(10), 908-929.
In this paper we report on an exploratory study with a group of 13 older women with intellectual disability in Sydney, Australia, to add to the limited knowledge about how they perceive their lives as they grow older. We report the findings from the qualitative data gathered as an extension of a structured interviewing process. Analysis revealed five themes: “it’s just who I am,” “enjoying support from family and friends,” “being part of the community,” “feeling healthy,” and having “enough money to buy what I need.” We discuss these themes in relation to the concept of resilience. Overall, the women we talked with were ageing well, with meaningful, productive, and sustainable lives.
Dodge, J. A., Janz, N. K., & Clark, N. M. (2002). The evolution of an innovative heart disease management program for older women: Integrating quantitative and qualitative methods in practice. Health Promotion Practice, 3(1), 30-42.
Few studies in the literature describe how to combine quantitative and qualitative methods to enhance the development of health education interventions. This article describes the evolution and refinement of an innovative disease management program “take PRIDE” for older adults with heart disease. Over 15 years, information obtained from data collection methods including telephone interviews, focus groups, face-to-face interviews, and program process data illuminated and guided subsequent refinement of the program and led to new iterations for different participants. Qualitative and quantitative data were incorporated into two key areas of program development (theoretical framework, objectives, format, and content) and evaluation (evaluation design, sampling, and measurement). Combining both types of data enhanced the opportunity to detect needed program changes, to increase understanding of the mechanisms by which the program effects were produced, and to enhance the relevance of the program to different groups of program participants.
Doress-Worters, P. B., & Siegal, D. L. (1994). The new ourselves, growing older (Rev. ed.). New York: Touchstone.
Like its predecessor, Our Bodies, Ourselves, this book builds upon the tradition of self-help and focuses on prevention and changes to create healthier life-styles. It is aimed at promoting self-acceptance of older and middle aged women by themselves and stresses the empowerment of midlife and older women in confronting the challenges of growing older. This is an informative book that covers a wide range of topics, including a variety of physical and mental ailments common to middle age and older women. Included throughout the text are practical tips for dealing with specific physical and mental problems. A resource guide in the back of the book lists articles of interest, a guide to community services and support groups.
The new and revised edition of the best-selling Ourselves, Growing Older includes new chapters on menopause and reform of the medical care system as well as extensive updates on housing issues, HIV/AIDS, cosmetic surgery, and breast cancer. Excerpts are available online at the book’s web site: http://www.ourbodiesourselves.org/ogohome.htm
Emlet, C. A., Tangenberg, K., & Siverson, C. (2002). A feminist approach to practice in working with midlife and older women with HIV/AIDS. Affilia, 17(2), 229-251.
Older women with HIV/AIDS constitute an invisible population that is often ignored by organizers of HIV prevention efforts as well as by HIV and aging organizations. This article explores the importance of a feminist approach to practice with a population affected by the intersection of ageism, sexism, and AIDS phobia. A support group for midlife and older women with HIV/AIDS is described, and four themes that were identified by the group participants are discussed. AIDS service organizations, the aging network, and policy makers must begin to recognize the critical need to support and assist older women with HIV/AIDS.
Folbre, N., Shaw, L. B., & Stark, A. (Eds.). (2005, July). Special issue on gender and aging. Feminist Economics, 11(2).
This volume focuses on gendered differences in the economic resources of the elderly and the individuals charged with meeting the day-to-day care needs of the elderly. Often the burden of care falls on women, who themselves have less access to care as they age. The introduction gives an overview of the public policy initiatives, social insurance and welfare programs, and family provisions for care that are thoroughly examined in the following contributions. The volume highlights both cross-national contrasts and common challenges to meeting the economic and care needs of the growing elderly population.
Gibson, D. (1996, August). Broken down by age and gender: “The Problem of Old Women” redefined. Gender & Society, 10(4), 433-448.
The last decade has seen the emergence of a feminist awareness of old age and, in particular, a growing awareness of what has come to be seen as “the problem of old women.” Old women, it has been consistently demonstrated, are disadvantaged in a variety of ways in relation to old men. They are poorer, older, and sicker; they have less adequate housing and less access to private transport; they are more likely to experience widowhood, severe disability, and institutionalization. Taking “the problem of old women” as its starting point, this article argues for a less phallocentric analysis of women in old age, which is less reliant on men as a relational category to define the conditions, experiences, and resources of older women.
Gill, C. J., & Brown, A. A. (2000). Overview of health issues of older women with intellectual disabilities. In J. Hammel & S. M. Nochajski (Eds.), Aging and developmental disability: Current research, programming, and practice implications [Special issue]. Physical & Occupational Therapy in Geriatrics, 18(1), 23–36.
Health researchers, educators and providers have begun to address the health needs of women and girls with disabilities in the U.S. Older women with intellectual disabilities, however, remain underrepresented in the national health research agenda. As this population becomes more visible and empowered through policies that support greater community integration and longevity, they and their families, professionals and advocates need more accurate information about their health concerns and options. A critical problem is that professionals receive little training regarding the health concerns and experiences of women with intellectual disabilities who are growing older. This paper provides an overview of primary health issues related to aging for women with intellectual disabilities in the following areas: (1) general health, (2) reproductive health, (3) mental health, and (4) access to health services. The paper concludes with a discussion of implications for practice and research, and recommendations for future research and health service provision for women with intellectual disabilities.
Gosselink, C. A., & Myllykangas, S. A. (2007, January). The leisure experiences of older U.S. women living with HIV/AIDS. Health Care for Women International, 28(1), 3-20.
Although leisure is held to provide positive health benefits, structural and social obstacles deny equal participation to the disenfranchised. Employing quantitative and unique qualitative (e.g., Photovoice) methods, we examined the leisure behaviors of older women who were living in the United States and diagnosed with HIV/AIDS. Findings pointed to differences in time for, access to, and meaning of leisure in pre- vs. post-infection leisure for these women. As the disease progressed, however, each woman exhibited resilience in transcending systemic barriers to derive a spiritual view of leisure as a metaphor for the meaning of life. We believe our findings of spiritual transcendence will resonate among people living with HIV/AIDS throughout both Western and non-Western cultures.
Han, B., Phillips, C., Ferrucci, L., Bandeen-Roche, K. et al. (2005, April). Change in self-rated health and mortality among community-dwelling disabled older women. The Geronologist, 45(2), 216-222.
Han et al. assess whether change in self-rated health is a stronger predictor of mortality than baseline self-rated health and the most recent self-rated health among disabled older women. Findings reveal that change in self-rated health is a stronger predictor of mortality than self-rated health at baseline and at the most recent observation. Older women with “fair” health are worse off if they are on a declining health trajectory than if their “fair” health is stable.
Harrison, T. (2003). Women aging with childhood onset disability: A holistic approach using the life course paradigm. Journal of Holistic Nursing, 21(3), 242-259.
Women with childhood onset disabilities (CODs) are living longer and it is time for holistic nurses to focus on understanding such women from a life course perspective. As women with CODs live into later adulthood, nurses must be prepared to anticipate and assist as needed. Without studies designed to understand the life course of these women, nursing can neither gain a clear understanding of the problems they face with aging nor help prevent the high number of social inequities, secondary conditions, and comorbidities experienced. To begin nursing’s exploration of the problems faced by women with CODs, the relevant historical changes and literature associated with aging with a COD are reviewed. Next, the life course paradigm is critically analyzed in relation to the lives of these women. In conclusion, it is posited that the life course paradigm provides the most useful guide for a holistic understanding of women with CODs.
Harrison, T., & Kahn, D. L. (2004, April-June). Perceived age, social integration, and disability: A case study of aging women. Journal of Loss & Trauma, 9(2), 113-129.
In this study, we used a qualitative case study design influenced by interpretive interactionism to explore how disability influences the perception of age and the social integration of three aging women. This study begins an important step toward understanding disability, aging, and social integration by bringing the reader into our conversation with three unique but similar women. These women expressed a perception of age younger than their chronological age; negative events associated with disability did not sway the women to perceive themselves as older than their stated age. Social integration varied depending upon their ability to find an environment that supported their chosen identity. Future studies are needed to provide further understanding of how women integrate the changes associated with disability into their social spheres during late adulthood.
Harrison, T. C., & Stuifbergen, A. (2005, September). Hermeneutic phenomenological analysis of aging with a childhood onset disability. Health Care for Women International, 26(8), 731-747.
In this qualitative study, we combined multiple interviews, field notes, life history review charts, and demographic questions to explore the life course experiences of 25 women, ages 55 to 65 years, who developed impairments due to paralytic polio during childhood. Based on a hermeneutic phenomenological methodology using thematic analysis, multiple themes emerged that traced their lives from childhood to later adulthood. The women described how they pushed their bodies and dismissed their physical decline as long as possible. The women’s early experiences combined with the culturally defined role expectations for women to influence their perceptions of how to react to changing physical abilities with age.
Healey, S. (1993, March-April). The common agenda between old women, women with disabilities and all women. In M. Fine (Ed.), Women with disabilities: Found voices [Feature issue]. Women & Therapy, 14(3/4), 65-78.
Popular belief assumes a common agenda between old women and women with disabilities. The stereotype is that all old women are disabled and all women with disabilities may as well be old; both groups are stigmatized and marginalized, even in the feminist community. While the two groups share social invisibility and oppression, they are different in terms of their history, political goals and philosophy. Both groups desire to distance themselves from each other; those who are disabled because they have too often been warehoused into nursing homes with the old, the old who may not be disabled and don’t want to face that possibility. Yet there exists compelling common ground as both groups struggle against their oppression. All women face a dual task: to confront their oppressor as well as their own internalization of that oppression. Since women with multiple oppressions are more sharply confronted with both tasks, they are on the cutting edge of the vital issues all women face. They can therefore become the teachers and heroes for all women in the common struggle for empowerment and freedom.
Hoffman, D. (1993). Complaints of a dutiful daughter [Film]. New York: Women Make Movies.
With profound insight and a healthy dose of levity, Complaints of a Dutiful Daughter chronicles the various stages of a mother’s Alzheimer’s Disease and the evolution of a daughter’s response to the illness. The desire to cure the incurable–to set right her mother’s confusion and forgetfulness, to temper her mother’s obsessiveness–gives way to an acceptance which is finally liberating for both daughter and mother. Neither depressing nor medical, Complaints of a Dutiful Daughter is much more than a story about Alzheimer’s and family caregiving. It is ultimately a life-affirming exploration of family relations, aging and change, the meaning of memory, and love.
Husaini, B. A., Sherkat, D. E., Levine, R., Bragg, R., Holzer, C., Anderson, K., Cain, V., & Moten, C. (2002). Race, gender, and health care service utilization and costs among Medicare elderly with psychiatric diagnoses. Journal of Aging and Health, 14(1), 79-95.
Objective: To investigate race and gender differences in health care service utilization and costs among the Medicare elderly with psychiatric diagnoses.
Methods: The authors employ a 5% sample of Medicare beneficiaries from Tennessee (N =33, 680), and among those with a psychiatric diagnosis (n =5, 339), they examine health care service utilization and costs by race and gender.
Results: African Americans had significantly higher rates of diagnosis for dementia, organic psychosis, and schizophrenia, whereas Whites had significantly higher rates for mood and anxiety disorders. White and African American men have higher rates of utilization of emergency and inpatient services and lower rates of outpatient utilization compared to White women and African American women. African American men have significantly higher health care costs.
Discussion: The findings suggest that race and gender interact to influence service utilization and preventive care, thereby driving up costs of care, for elderly persons with psychiatric diagnoses.
Katz, S. J., Kabeto, M., & Langa, K. M. (2000). Gender disparities in the receipt of home care for elderly people with disabilities in the United States. Journal of the American Medical Association (JAMA), 284(23), 3022-3027.
Study examining sex-based differences in receipt of informal and formal home care by older adults with disabilities. Data are from a nationally representative survey conducted in 1993 among 7443 noninstitutionalized people (4538 women and 2905 men) age 70 or older, of whom 3109 reported impairments in activities of daily living (ADL) or instrumental activities of daily living (IADL). Results show that women with disabilities received fewer hours of informal care than men with disabilities. Women with disabilities tended to receive care from children, while men with disabilities tended to receive care from wives. No significant differences were found in receipt of formal care.
Kilbourne, B. E., Baltrus, P. A., Williams-Brown, S., Caplan, L., Briggs, N. C., Roberts, K., Husaini, B. A., & Rust, G. E. (2008). Black-white disparities in elderly breast cancer mortality before and after implementation of Medicare benefits for screening mammography. Journal of Health Care for the Poor and Underserved, 19(1), 103-134.
Background. Medicare implemented reimbursement for screening mammography in 1991.
Main Findings. Post-implementation, breast cancer mortality declined faster (p=.0001) among White than among Black elderly women (65+ years). No excess breast cancer deaths occurred among Black elderly compared with White elderly through 1990; over 2,459 have occurred since. Contextual socioeconomic status does not explain differences between counties with lowest Black breast cancer mortality/post-implementation declines in disparity and counties with highest Black breast cancer mortality/widened disparity post-implementation.
Conclusions. The results lead to these hypotheses: (a) Medicare mammography reimbursement was causally associated with declines in elderly mortality and widened elderly Black:White disparity from breast cancer; (b) the latter reflects inherent Black-White differences in risk of breast cancer death; place-specific, unaddressed inequalities in capacity to use Medicare benefits; and/or other factors; (c) previous observations linking poverty with disparities in breast cancer mortality are partly confounded by factors explained by theories of human capability and diffusion of innovation.
Kvingne, K., & Kirkevold, M. (2002). A feminist perspective on stroke rehabilitation: The relevance of de Beauvoir’s theory. Nursing Philosophy, 3, 79-89. Retrieved March 31, 2005 from http://www.blackwellpublishing.com/pdf/nup_kvigne.pdf
The dominant view of women has changed radically during the last century. These changes have had an important impact on the way of life of women in general and, undoubtedly, on women as patients. So far, gender differences have received little attention when developing healthcare services. Stroke hits a great number of elderly women. Wyller et al. found that women seemed to be harder hit by stroke than men; they achieved lower scores in tests of motor, cognitive and ADL functions, both in the acute phase and 1 year after stroke. It is reasonable to expect that differences in outcome among male and female sufferers may in part be explained by the fact that rehabilitation services are designed primarily to meet the needs of men. de Beauvoir’s feminist theory maintains that one’s body is fundamental in creating the person, which is a lifelong process. Traditionally, the female body has been exposed to alienation and oppression through life. This has led women to develop a life in immanence. This we feel can be of significance in connection with rehabilitation after a stroke, particularly for elderly women. In this article we will discuss how de Beauvoir’s theory can throw new light on the experiences and rehabilitation of elderly women and point to ways of improving the process of rehabilitation.
Lamb, V. L. (1997, July). Gender differences in correlates of disablement among the elderly in Egypt. Social Science and Medicine, 45(1), 127-136.
The purpose of this paper is to examine gender-specific models to determine whether different combinations of correlates are associated with male and female disablement, using a sample of non-institutionalized elderly persons in Egypt. Because women and men have different work, family, and household roles, as well as different health risks, it is reasonable to assume that there may be differing correlates for disablement for elderly males and females. The dichotomous dependent variable indicates problems, or the inability, in performing at least one of six activities of daily living (ADL). Of interest is the association of health, economic, and family variables, controlling for age. Logistic regression models are estimated for the total, male, and female samples. The results indicate that for males, having to stop working due to illness and having an unattended medical need are associated with higher odds for disablement as compared with females. Additionally, illiteracy increases the odds for male disablement, yet it has no effect on female disablement. Having experienced an injury in the past year is associated with disability for females, as is spending a lifetime in a rural setting and currently living in a fair to poor residence. Also for the females, increased number of living children significantly increases the odds for functional disability. Separate male and female models were estimated for each of the six ADL items. The trends indicated that the model covariates were more useful in modeling female disabilities in personal care activities, rather than problems with eating and mobility. The health variables were significantly associated with most of the specific ADL problems for the males.
Lee, E. O., & Brennan, M. (2002). ‘I cannot see flowers but I can smell them’: The relation of age and gender to self-reported coping strategies among older adults with visual impairment. Qualitative Social Work, 1(4), 389-411.
We examined self-reported coping strategies used by older visually impaired adults as related to age and gender. Narrative data from two previous studies of adaptation to vision impairment (n = 155 and n = 343, respectively) were analyzed with qualitative methods. Results indicated that both age and gender were related to the coping strategies reported. The old-old were less motivated to use rehabilitation training and withdrew socially. Women were more likely to utilize non-family social supports, while men relied on immediate family. These findings underscore the complexity of needs in the older visually impaired population. Implications of these findings for practitioners working with this population are discussed.
Leveille, S. G., Resnick, H. E., & Balfour, J. (2000, April). Gender differences in disability: Evidence and underlying reasons. Aging, 12(2), 106-102.
Women have greater longevity than men and represent a larger proportion of the expanding older population. Several health, disease, behavioral and sociodemographic factors contribute to the higher prevalence of disability in women compared to men. This paper presents a review of methodologic and epidemiologic considerations important to our understanding the gender differences in the prevalence of disability, and discusses underlying causes for these differences. Compared to men, women have a longer duration of life lived with disability, in part due to higher prevalence of non-fatal chronic conditions, constitutional factors such as lower muscle strength and lower bone density, and higher rates of life-style factors such as sedentary behavior and obesity. Several of these factors are modifiable, and provide important targets for researchers, clinicians, and public health practitioners in their efforts to reduce the burden of disability in the older population.
LeRoy, B. W., Walsh, P. N., Kulik, N., & Rooney, M. (2004, September). Retreat and resilience: Life experiences of older women with intellectual disabilities. American Journal on Mental Retardation, 109(5), 429-441.
Older women with intellectual disabilities remain the least studied and understood members of the disability population, and yet they often live well into late adulthood. In this exploratory study we used extensive interviews to examine the demographics, economic and personal safety nets, health, social roles, and well-being of 29 Irish and American older women with intellectual disabilities. Results suggest that these women have very limited resources, social networks, and opportunities. All the women were poor and most lived in group residences, with paid staff as their main allies and care providers. They reported that their health was good, though it often limited their activities. Despite their societal limitations, these women reported this is the happiest period of their lives.
Mayberry, P. S., & Seltzer, M. M. (1993). Older women in southwestern Ohio: Long-term care needs and resources. Oxford, OH: Scripps Gerontology Center, Miami University. Retrieved March 7, 2005 from http://digital.lib.muohio.edu/scripps/31482453.pdf
As the primary consumers and providers of long-term care in this country, women are disproportionately affected by the degree to which a range of long-term care services are available and accessible. This project used information from existing needs assessment data, focus group discussions with older women, and interviews with service providers to better understand the long-term care needs of older women.
McGrew, K. B. (1991). Daughters’ decision making about the nature and level of their participation in the long-term care of their dependent elderly mothers: A qualitative study. Oxford, OH: Scripps Gerontology Center, Miami University. Retrieved March 7, 2005 from http://www.scripps.muohio.edu/scripps/publications/
This report offers the results of a qualitative study which explored the decision making process for daughters regarding the nature and level of their participation in the long-term care of their elderly mothers.
McColl, M. A., Charlifue, S., Glass, C., Lawson, N., & Savic. G. (2004). Aging, gender, and spinal cord injury. Archives of Physical Medicine and Rehabilitation, 85(3), 363-367.
Study examined the experience of aging in men and women with spinal cord injury (SCI). Data was collected through interviews and mailed, self-administered questionnaires from participants in 3 countries: Canada, England, and the United States. Although both sexes rated their quality of life equally, women described their aging experience as “accelerated” while men described it as “complicated”. Women reported more effects of pain, fatigue, and skin problems and more transportation problems. Men reported more health problems, diabetes, and adaptive equipment changes. Older men and women with SCI spent their time differently; men spent more time working and women spent more time homemaking.
McFadden, S. H. (2001, February). Feminist scholarship as a meeting ground for age and disability studies [Book review]. The Gerontologist, 41(1), 133-137.
This is a review of two books where as the author analyzes the texts, she suggests that feminist theory could serve as a connection between gerontology and Disability Studies.
Mehdizedeh, S. A. (2002). Health and long-term care use trajectories of older disabled women. The Gerontologist, 42(3), 304-314.
Purpose: I examined health and long-term care use trajectories of a sample of chronically disabled older women eligible for both Medicare and Medicaid by exploring their use data in order to understand and anticipate the increasing demand on the health and long-term care delivery systems as aging female baby boomers reach age 65 and older.
Design and Methods: A sample of older disabled women in Ohio who completed preadmission review was divided into three groups on the basis of the setting in which they received their initial long-term care services.
Results: I was able to establish a long-term care career for the sample members beginning with receiving long-term care in the community, followed by a transition stage in which care was received in the community and in a nursing home, and finally by a stage at which they entered and remained in a nursing home. As the sample members proceeded along their long-term care career and their health and disability status worsened, I found a clear shift in the kind of care needed from hospital and home care to nursing home care. There was also a shift in the major payer, from Medicare to Medicaid.
Implications: As the baby boomers age, a much larger number of women will be disabled and need health and long-term care services. For a considerable number of these women, Medicaid gradually becomes the major payer for care, an issue that needs close observation.
Morell, C. (2004). Empowerment theory and long-living women: A feminist and disability perspective. In N. J. Smyth (Ed.), Women and girls in the social environment: Behavior perspectives [Special issue]. Journal of Human Behavior in the Social Environment, 7(3/4), 225-236.
Empowerment theory is central to social work and to feminist gerontology. Yet an emphasis on increasing power and control over the circumstances of one’s life does not neatly “fit” the involuntary bodily realities that figure centrally in the experiences of late age. The project of this article is to argue that the paradox of late life empowerment is that it requires acceptance and affirmation of the weak, suffering, and uncontrollable body. This is one of 12 articles of a special issue on women and girls in the social environment.
Moss, P. (1997, July). Negotiating spaces in home environments: Older women living with arthritis. Social Science and Medicine, 45(1), 23-33.
Within medical geography there has been a surge of interest in applying critical concepts in social theory to empirical settings, including those for persons with disabilities. The ways through which persons with disabilities negotiate space vary widely according to material and social experiences of being disabled. For older women, chronic illness as a type of disability shapes the way in which they approach their daily lives with respect to both the physical and social aspects of their home environments. In the first half of the paper, conceptually, I take a relational view of space and argue that household, as a narrow reading of domestic space, needs to be replaced by home environment which incorporates more fully age- and ablement-sensitive readings of the spaces constitutive of domestic space. This lays the basis for a contextualized socio-spatial understanding of the ways older women with chronic illness negotiate the spaces in home environments because it accounts for the disadvantaged positionings of access to power and resources as well as the uneven distributions of income based on gender, age, and (dis)ability. It also takes into account the material and social aspects of being disabled. In the second half of the paper, I present case studies of three older women diagnosed with rheumatoid arthritis to illustrate these arguments.
Peek, M. K., & Coward, R. T. (1999, May). Gender differences in the risk of developing disability among older adults with arthritis. Journal of Aging and Health, 11(2), 131-150.
Although older women are disabled from arthritis at higher rates than men, there is an inadequate understanding of the factors that place women at higher risks. The purpose of this research is to improve understanding of gender differences in the process of becoming disabled among older adults with arthritis. Methods: Gender differences in risk factors associated with developing a disability during a 30-month period are examined among a sample of noninstitutionalized elders with arthritis (N = 749). Results: Results from discrete time-hazard models indicate that sociodemographic factors account for gender differences in disability with activities of daily living (ADLs). However, for difficulties performing instrumental activities of daily living (IADLs), gender differences remain unexplained by variations in demographic and health factors. Discussion: More descriptive and explanatory work needs to focus on gender differences in IADL disability; however, these finding suggest that the gendered nature of the IADL tasks influences gender differences in IADL disability.
Pentland, W., Miscio, G., Eastabrook, S., & Krupia, T. (2003). Aging women with schizophrenia. Psychiatric Rehabilitation Journal, 26(3), 290-302.
Article presents findings of a study that examined the experiences of aging women with schizophrenia, their perceived concerns and issues, and how they cope with aging. All of the participants reported feeling that their lives have improved with age, despite traumatic losses and suffering in the past and physical declines that currently make doing things harder. The women expressed that life is better because they have fewer responsibilities, their schizophrenia is improving, and they understand themselves better. Major concerns expressed were their future mental and physical health, and who will care for them if they get sick. The women developed numerous coping strategies that help them deal with their symptoms as well as support from family and friends, health care professionals and medication, their lodging home and its staff, and community health services.
Plach, S. K., Stevens, P. E., & Keigher, S. (2005). Self-care of women growing older with HIV and/or AIDS. Western Journal of Nursing Research, 27(5), 534-553.
The purpose of this report is to describe the ways older women living with HIV perceive of and practice self-care. Data are taken from a culturally diverse subsample of 9 women age 50 years or older who participated in a larger longitudinal qualitative study of women who were HIV infected. During a period of 2 years, 10 semistructured narrative interviews were conducted with each of the 9 participants to gain an in-depth understanding of their experiences with symptom management, adherence to medical regimens, reduction of HIV risk, access to health care and social services, and personal efforts to maintain their health. Transcribed data were managed using Nvivo software and analyzed using multistaged narrative analysis. Findings suggest that mature women living with HIV integrate actions to maintain bodily comfort and improve physical well-being with actions that champion and conserve the existential self. Excerpts from their interviews illustrate this dialectical understanding of self-care.
Proctor, G. (2001, May). Listening to older women with dementia: Relationships, voices and power. Disability & Society, 16(3), 361-376.
Four older women with dementia were interviewed about their experiences of their services. People with dementia are rarely asked for their opinions or judged to be fully legitimate persons. Gaps in previous research concerning people with dementia is presented, with respect to listening to people with dementia themselves and with respect to gender issues. The present study is described and the methodology for analysis, Brown and Gilligan’s Voice Relational Method, is presented. This method was developed to listen to adolescent girls and has been used to listen to the voices of others who are disempowered in society. Its focus on relationships and issues of power was useful in this study. The methodology is presented in the context of debates within feminist and disability research. The results of the interviews are discussed, particularly with respect to power in the women’s relationships, and particularly the relationships between the women with dementia and medical staff. Some implications of these power issues are presented and recommendations are made.
Stehlik, D. (2000, January). Aging mothers and aging daughters: Life-long caring and intellectual disability. Journal of Women & Aging, 12(1&2), 169-187.
While aging and caring are well-discussed in academic literature, the association among aging, caring and intellectual disability is less well documented. This paper draws on a recently completed Australian study which focuses on such mother/daughter relationships and whose narratives form the framework for an argument for a re-imagining of the concept of care for aged people with intellectual disability. Specifically, using a genealogical approach, the paper describes how powerful discourses at the time of the daughter’s birth (1940s and 1950s) -associated with eugenics, institutional care and motherhood -are framing the way in which aging mothers are now contemplating the future care for their adult (and also aging) daughters.
Walker, M. B. (1999). Mother time: Women, aging, and ethics. New York: Rowman & Littlefield Publishers, Inc.
Fifteen original essays open up a novel area of inquiry: the distinctively ethical dimensions of women’s experiences of and in aging. Contributors distinguished in the fields of feminist ethics and the ethics of aging explore assumptions, experiences, practices, and public policies that affect women’s well-being and dignity in later life. The book brings to the study of women’s aging a reflective dimension missing from the empirical work that has predominated to date. Ethical studies of aging have so far failed to emphasize gender. And feminist ethics has neglected older women, even when emphasizing other dimensions of difference. Finally work on aging in all fields has focused on the elderly, while this volume sees aging as an extended process of negotiating personal and social change.
Walsh, P. N. (2002, July-August). Life members: Women with intellectual disabilities and aging. In M. P. Janicki & P. McCallion (Eds.), Aging people with intellectual disabilities: Dealing with the challenges of older age, Part II [Special issue]. Journal of Gerontological Social Work, 38(1/2), 121-136.
The author reviews some of the dilemmas faced by women with intellectual disabilities as they age and are trying to stake out a place in their communities. It draws on recent testimony of older women themselves, their carers and advocates about optimal paths to healthy aging. The author suggests that more flexible, individualized forms of support are likely to enhance the quality of longer lives and that supports for women with intellectual disabilities can be appraised in terms of efficacy in strengthening women’s membership of their respective communities as they age. The author speaks to the implications for best practice on the part of professionals and other carers who work with and support women as they age and proffers suggested research strategies for future women’s studies.
Walsh, P. N., & LeRoy, B. (2004). Women with disabilities aging well: A global view.
Baltimore: Paul H. Brookes Publishing Co.
The focus of this book is on women with developmental disabilities and what they experience when they age and what service providers and researchers can learn from their stories. Includes oral histories of over 160 women in eighteen countries.
Walsh, P. N., Heller, T., Schupf, N., & van Schrojenstein Lantman-de Valk, H., & Working Group. (2000, January). Healthy aging – Adults with intellectual disabilities #2: Women’s health and related issues: A report of the Aging Special Interest Research Group of the International Association for the Scientific Study of Intellectual Disabilities. Geneva, Switzerland: World Health Organization. Retrieved March 18, 2005 from http://www.uic.edu/orgs/rrtcamr/womenshealthreport.html
“This report is concerned with issues which are important for the health of women with intellectual and developmental disabilities as they grow older and age. The specific focus on women’s health is in no manner meant to be dismissive or designed to minimize concerns related to men’s health issues. However, it is the position of the SIRG on aging that women’s health issues have not received appropriate and sufficient attention, that women as they age are subject to sex-related conditions and changes, and that in many instances the interests and needs of aging women and women with disabilities are overlooked or neglected. Thus, this report is designed to explore factors related to well-being and quality of life for women, to examine and define sex-linked differences in their life experiences and opportunities and to define their distinctive vulnerabilities–including research on health status and access to health care.”
Zautra, A. J., & Smith, B. W. (2001). Depression and reactivity to stress in older women with rheumatoid arthritis and osteoarthritis. Psychosomatic Medicine, 63(4), 687-696.
Objective: The purpose of this study was to examine the role of depressive symptoms in reactivity to stress and pain in older women with rheumatoid arthritis (RA) and osteoarthritis (OA).
Methods: Participants were 188 older women with RA (N = 87) and OA (N = 101). They were initially assessed for depressive symptoms and interviewed weekly for 12 to 20 weeks regarding interpersonal stress, arthritis pain, and negative affect.
Results: Hierarchical linear modeling (HLM) revealed that depressive symptoms were related to weekly elevations in arthritis pain, negative events, perceived stress, and negative affect for RA respondents and elevations in arthritis pain and negative affect for OA respondents. HLM analyses also indicated that depressive symptoms were related to increased reactivity to perceived stress and arthritis pain in people with RA, but not those with OA.
Conclusions: Depression may be related to elevations in pain for people with RA and OA and to elevations in stress and increased reactivity to stress and pain for those with RA.