Social Lives and Cliques Within Senior Housing Communities.

A better understanding of social environments will benefit facilitation of social cultures within senior housing communities. Social cliques naturally form among groups of people, particularly those living in close proximity. Research has shown that often older adults experience stigma based upon their health status and are excluded from social groups. This study examined residents' perceptions of life in senior housing, social stigma, and cliques. Forty-eight residents from two types of senior housing communities participated in the study. Qualitative thematic coding was used to analyze responses to open-ended interview questions. Overall, residents reported satisfaction with the community and their privacy and reported difficulties with distance from family, caregiving, and bereavement. The majority were able to identify cliques, defining them based upon common interests, health status, and shared histories. The most salient finding was that while social cliques existed they were not a source of dissatisfaction or stigma.

The rote administrative approach to death in senior housing: Using the other door.

Understanding death in long-term care (LTC) facilities and the preexisting standards and policies pertaining to the death experience in LTC is essential. Qualitative interviews were conducted with 10 administrators of CCRCs and data analyzed through content analysis. Results of the current study reveal that administrators spoke of approaching death in their facility similar to any other procedural task, removal of the residents' bodies varied by community, and coordination responsibilities ranged from maintenance crews to management. Notification practices for residents and staff were also inconsistent. Differences existed in internal cultures on providing forms of respect. These practices were standard for some facilities while others were flexible to accommodate family requests. The majority of the sites did not offer additional training on death and dying for staff members. Findings suggest the need for consistency regarding how senior housing administrators approach the death of a resident and provide support for staff members.

Institutional Bereavement Care for Fictive Kin: Staff Grief in CCRCs.

PURPOSE: The purpose of this study was to explore approaches used by administrators to respond to grief and bereavement among staff after the death of a resident. METHODS: Continuing care retirement community (CCRC) facilities (n = 10) were randomly selected from a larger study of 31 facilities. Open-ended interviews were conducted using a structured interview protocol. Qualitative methods, specifically thematic analysis, were used to analyze the interview data. FINDINGS: Emergent themes suggest that LTC facilities have freedom in how to provide support for staff members, family members, and other residents after the death of a loved one. However, results show variations in methods for notifying staff of a resident's death, inclusion of direct care staff in caring for the deceased, providing memorial services, and offering grief/bereavement support. When speaking of the loss of a resident and ways to provide grief/bereavement support, only 3 of the 10 administrators discussed the importance of extending such services to the staff. IMPLICATIONS: Causes of staff burnout in the CCRC workplace is an unresolved issue. Research has shown that inadequate grief and bereavement support for staff contributes to factors associated with staff burnout and retention. Although administrators hold formal services after a resident has died, there are differences among facilities. It may be that organizations could improve bereavement services for staff.

A portrait of resilience in caregiving.

The current study investigated biopsychosocial resilience in an older adult caregiver. A case study was selected for in-depth exploration of resilience in caregiving identified through biopsychosocial (i.e., salivary cortisol) methods. An exemplar of a woman caring for an adult child dying from a genetic disease is presented in the context of multiple stressors. Significant stress was found to be buffered by cognitive reframing and acceptance of interpersonal limits. Early experiences in caregiving for others with terminal illnesses provided a frame of reference, and difficult family dynamics added a layer of complexity. During periods identified as stressful, cortisol levels rose outside of normal bounds. The study implications are that mixed-methods (i.e., biopsychosocial) studies yield important results on individual differences within similar contexts.

R-spondin1 deficiency enhances ß-Cell neogenesis in a murine model of diabetes.

OBJECTIVE: The cWnt activator, R-spondin1 (Rspo1), regulates ß-cell growth, function, and neogenesis, although its role in conditions such as streptozotocin (STZ)-induced diabetes is unknown. We hypothesized that Rspo1 deficiency enhances ß-cell neogenesis in STZ-induced diabetes. METHODS: Wild-type (Rspo1) and knockout (Rspo1) mice were injected with STZ (40 mg/kg) for 5 days, followed by analysis of oral glucose and insulin tolerance, and were killed on day 6 (acute; 9-11 mice) or 32 (chronic; 11-16 mice). Immunohistochemistry was performed for ß-cell apoptosis, proliferation, neogenesis, and markers of ß-cell maturity. RESULTS: There was no difference in oral glucose handling between STZ-induced Rspo1 and Rspo1 mice, although Rspo1 mice demonstrated increased insulin sensitivity. ß-cell mass, islet number, and islet size distribution did not differ between STZ-induced Rspo1 and Rspo1 mice, but Rspo1 animals had reduced ß-cell apoptosis and increased numbers of insulin-positive ductal cells, indicating ß-cell neogenesis. Furthermore, the increased ß-cell regeneration observed in the Rspo1 animals was associated with a more differentiated/mature ß-cell phenotype as assessed by increased immunopositivity for Nkx6.1, MafA, and GLUT2. CONCLUSIONS: These findings indicate that Rspo1 is a negative regulator of ß-cell neogenesis, development, and survival in the face of STZ-induced diabetes, providing a therapeutic target for the enhancement of ß-cell mass.