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Iranian American Older Adults’ Attitudes and Proactive Actions Toward Planning Ahead for End-of-Life Care
Title
Iranian American Older Adults’ Attitudes and Proactive Actions Toward Planning Ahead for End-of-Life Care.
Creator
Rahemi, Zahra, Dunphy, Lynne M., Florida Atlantic University, Christine E. Lynn College of Nursing
Abstract/Description
Ethnically diverse older adults are the fastest growing population in the U.S. This population may experience transitional processes associated with immigration, acculturation, aging, and end of life (EOL). Advances in technology lead to increases in care options, which can cause uncertainty to make decisions for EOL. Unmade decisions about care prior to becoming unable to communicate are associated with burdens of last-minute decisions at EOL, unwanted intensive EOL treatments for people who...
Show moreEthnically diverse older adults are the fastest growing population in the U.S. This population may experience transitional processes associated with immigration, acculturation, aging, and end of life (EOL). Advances in technology lead to increases in care options, which can cause uncertainty to make decisions for EOL. Unmade decisions about care prior to becoming unable to communicate are associated with burdens of last-minute decisions at EOL, unwanted intensive EOL treatments for people who may die naturally of old age, financial and emotional costs, and decreased quality of life. In the U.S., a multicultural country with a variety of care options, advance directive (AD) completion and advance care planning (ACP) may improve culturally competent and person-centered care at EOL. However, the rate of AD completion and ACP is low among Americans, especially immigrant communities. These communities, including Iranian-American older adults, have been frequently understudied, and there is a gap in studies of EOL desires, attitudes, and actions/behaviors. This inquiry focused on planning ahead for EOL care across transitional processes that older immigrants may face. The aim was to enhance culturally competent care for older adults through distinguishing significant factors, which may influence planning for EOL care. Specific purposes were: To identify relationships between attitudes toward planning for EOL care and social supports, spirituality, healthcare system distrust, and acculturation; to identify a relationship between attitudes and proactive actions toward planning ahead in Iranian-American older adults. Conceptual frameworks for this descriptive, cross-sectional study included Culture Care Diversity and Universality and Transitions theories. Findings from 135 participants revealed that they were new immigrants to the U.S. (mean year of 23 in the U.S., 97% born in Iran) and highly educated and insured with high health statuses. About 55% preferred non-intensive treatments and/or homecare at EOL, and 52.6% had not communicated their EOL wishes. Attitudes toward planning ahead for EOL were positively associated with acculturation and healthcare system distrust, and negatively associated with spirituality. No significant association was found between attitudes and social support. Furthermore, favorable attitudes predicted higher proactive actions to communicate wishes. Implications for practice, policy, education, and recommendations for further studies were discussed.
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Date Issued
2017
PURL
http://purl.flvc.org/fau/fd/FA00004939
Subject Headings
Older people--Long-term care., Advance directives (Medical care), Health planning--United States., Right to die., Life care planning., Terminal care--Moral and ethical aspects., Immigrants--Psychology.
Format
Document (PDF)
Care at Work: A Feminist Analysis of the Long-Term Care Industry in the United States
Title
Care at Work: A Feminist Analysis of the Long-Term Care Industry in the United States.
Creator
Tunick, Rachel, Beoku-Betts, Josephine, Lange, Bernadette, Florida Atlantic University, Dorothy F. Schmidt College of Arts and Letters, Center for Women, Gender and Sexuality Studies
Abstract/Description
This research provides a feminist perspective on the lowest paid sector of the United States long-term care industry, Certified Nursing Assistants. This research adds to current feminist scholarship on the modern professional caregiving industry by focusing on the perspective of the workers. As the population of older adults requiring care is expected to increase over the coming decades, the demand for paid caregivers will increase as well. Historically, care work was an expected duty done...
Show moreThis research provides a feminist perspective on the lowest paid sector of the United States long-term care industry, Certified Nursing Assistants. This research adds to current feminist scholarship on the modern professional caregiving industry by focusing on the perspective of the workers. As the population of older adults requiring care is expected to increase over the coming decades, the demand for paid caregivers will increase as well. Historically, care work was an expected duty done freely by the women of the family, but today much of the vital intimate caring labor is relegated to paid caregivers. I examine how alternative social, political and economic frameworks can transform United States society’s attitude towards the increasingly relevant issue of caring labor. I argue that incorporating a feminist perspective will be helpful in developing a sustainable model for caring labor that acknowledges the dignity of both patients and their caregivers.
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Date Issued
2016
PURL
http://purl.flvc.org/fau/fd/FA00004801, http://purl.flvc.org/fau/fd/FA00004801
Subject Headings
Nurses' aides., Medical personnel-caregiver relationships., Nursing homes--Employees--Attitudes., Feminist theory., Caring--Moral and ethical aspects., Feminism--Political aspects., Long-term care facilities--Administration., Nursing home patients--Care., Older people--Nursing home care.
Format
Document (PDF)