"Without Compassion We Don't Have a Social Work Field": A Thematic Analysis Exploring Social Workers' Experiences with Compassion.

PURPOSE: Evidence establishing the importance of compassion in the context of social work practice is emerging. Compassion, stemming from the Latin words com and pati, means to suffer with. Given the proximity social workers have to vast experiences of suffering, compassion may play a central role in providing meaningful care to individuals, communities, and systems. The purpose of this qualitative study was to explore social workers' definitions of and experiences with compassion. METHOD: Participants included 12 social workers working across levels of practice in two Midwestern states in the United States. Data were collected via semi-structured interviews. RESULTS: Thematic analysis demonstrated three themes present in the data. Consistent with previous conceptual scholarship, the findings illustrated that compassion is a central component of social work practice. Additionally, results from the study demonstrated that social workers find compassion to be an imperative component of ethical practice and suggested that both barriers to and facilitators of compassion are present across levels of social work practice. DISCUSSION AND CONCLUSION: This study adds to the growing body of social work scholarship exploring compassion and highlights implications for the social work discipline across levels of practice to more overtly center compassion in education, practice, and policy. Further research is needed to better understand multilevel barriers to compassion and develop strategies for overcoming them. Moreover, additional research is needed to holistically understand how to leverage and build upon the facilitators of compassion identified by participants in order to foster compassionate social workers, social work organizations, and systems.

"Courage to cobble something new": Women's queer and creative narratives of bisexuality and ageing.

Critical gerontologists have called for more diverse and inclusive visions of a good old age, and especially for imaginings that do not depend on health, wealth and heterosexuality. They have suggested that LGBTQ people, alongside other marginalized groups, may have particular contributions to make to the project of reimagining ageing. In this paper, we bring together this work with Jose Muñoz's concept of 'cruising utopia' to examine possibilities for imagining a more utopian, queer life course. We present findings from a narrative analysis of Bi Women Quarterly, a grassroots online bi community newsletter with an international readership, analyzing three issues published between 2014 and 2019 that focused on the intersection of ageing and bisexuality. We found several ways in which the authors told counter-narratives that queered normative visions of successful ageing. They queered norms around the stability and reification of sexual and gender identities. They challenged current forms of LGBTQ activism. They embraced and celebrated ageing, through such activities as croning ceremonies, and directly addressed and contemplated death. Finally, they queered the narrative form, by giving accounts of personal experience that were dreamlike, poetic or inconclusive. We conclude that counter-normative spaces, such as activist newsletters, offer valuable resources to progress the wider project of reimagining successful ageing more inclusively.

A qualitative exploration of caregivers' experiences with the Attachment and Biobehavioral Catch-up (ABC) parenting program.

In the face of childhood adversity, services and interventions can improve a child's life trajectory by promoting healthy development, enhancing protective factors, and building resilience through stable and supportive relationships. One such service, a specific and highly researched home visiting intervention, Attachment and Biobehavioral Catch-up (ABC), is often provided to families through home visiting service programs. This qualitative descriptive study examines the experiences of caregivers (N = 18) who received ABC as part of a statewide early childhood initiative in one midwestern state. Participants provided insight into the context of their lives before and during the intervention. They described their perspectives of the utility of the program and its influence on their family's behaviors and interactions. Findings demonstrate that coaching support bolstered caregivers' confidence in effective strategies and guided them through caregiving challenges. Caregivers observed growth in their caregiving practices, their infants' and young children's social and emotional skills, and their dyadic caregiver-child relationships, demonstrating the benefits of participating in and completing the ABC intervention.

Ante las circunstancias adversas en la niñez, los servicios e intervenciones pueden mejorar la trayectoria de vida de un niño promoviendo un desarrollo saludable, mejorando los factores de protección y generando fortaleza a través de relaciones estables y de apoyo. Uno de tales servicios, una intervención específica de visita a casa, bien investigada, el Alcance de la Bio-Conducta de Afectividad (ABC), se les proporciona a menudo a familias a través de programas que prestan el servicio de visitas a casa. Este descriptivo estudio cualitativo examina las experiencias de quienes prestan el cuidado (N = 18) que recibieron el ABC como parte de una iniciativa estatal sobre la temprana niñez en un estado del medio oeste. Los participantes aportaron ideas en cuanto al contexto de sus vidas antes y durante la intervención. Describieron sus perspectivas acerca de la utilidad del programa y las influencias de este sobre los comportamientos e interacciones de sus familias. Los resultados demuestran que el apoyo de entrenamiento reforzó la confianza de quienes prestan el cuidado en estrategias eficaces y los guió a través de los retos en la prestación del cuidado. Los cuidadores notaron crecimiento en sus prácticas de prestación del cuidado, las habilidades sociales y emocionales de sus niños, así como en las relaciones diádicas entre cuidador y niño, lo cual demuestra los beneficios de participar y completar la intervención ABC.

Face à l'adversité de l'enfance, les services et les interventions peuvent améliorer la trajectoire de vie d'un enfant en promouvant un développement sain, en améliorant les facteurs de protection, et en construisant une résilience au travers de relations stables et favorables. Un de ces services, une intervention à domicile spécifiques et ayant fait l'objet de nombreuses recherches, le Rattrapage Biocomportemental d'Attachement (soit en anglais Attachment Biobehavioral Catchup ici abrégé ABC), est souvent offert aux familles au travers de programmes de visite à domicile. Cette étude descriptive qualitative examine les expériences de personnes prenant soin d'enfant (N = 18) qui ont reçu l'ABC parce qu'il fait partie d'une initiative d'enfance précoce dans un état, dans un état du centre des Etats-Unis d'Amérique. Les participant(2)s ont donné un aperçu du contexte de leurs vies avant et durant l'intervention. Ils ont décrit leurs perspectives quant à l'utilité du programme et son influence sur les comportements et les interactions de leur famille. Les résultats démontrent que le soutien d'un coach a renforcé leur confiance en des stratégies efficaces et les ont guidés au travers des défis qu'il y a à prendre soin d'un enfant. Les participant(e)s ont observé une croissance dans leurs pratiques de soin, dans les compétences sociales et émotionnelles des enfants et dans leur relation dyadique personne prenant soin de l'enfant-enfant, prouvant ainsi les bénéfices qu'il y a à participer et à terminer l'intervention ABC.

Context-dependent sexual changes during women's midlife transitions.

For women, midlife represents an important stage of transition, including shifts in physiological, social, and sexual experiences. Prior research demonstrates that women's sexuality is more dynamic and context-dependent than men's. Most research focused on women's sexuality in mid- to later-life emphasizes physiological changes, while largely ignoring changes stemming from social, psychological, and relational contexts. The present study examined midlife women's diverse sexual experiences within the context of their lives. We conducted semi-structured interviews with 27 women, ages 39-57, and used interpretative phenomenological analysis to investigate perceptions and interpretations of midlife sexual experiences and changes. Themes included changes in sexual engagement, unwanted sexual experiences, body image, and sexual healthcare. Participants reported changes in the frequency of sex and sexual desire within the context of their diverse social roles and identities, prior intimate relationships, and sexual health. Women contrasted perceptions of their own bodies with societal perceptions of sexiness. Frequently reported negative experiences with sexual healthcare informed a distrust of healthcare systems. The diverse and changing nature of participants' experiences supports prior evidence of sexual fluidity and context-dependence. By questioning societal expectations around sexuality and body image, participants illustrated the potential of counternarratives to combat dominant beliefs and stereotypes about midlife women's sexuality. To improve sexual health and education, psychoeducational interventions for women in midlife are needed.

Stress and Resilience among Sexual and Gender Diverse Caregivers.

Little is known about caregiving outcomes of sexual and gender diverse, including LGBT, caregivers. Informed by the Health Equity Promotion Model (HEPM) and Pearlin's Stress Process Model, we utilized data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), to examine perceived stress among a sample of 754 sexual and gender diverse caregivers using regressions on background and caregiving characteristics and risk and protective factors. Among caregivers, 38% were providing care to a spouse or partner and about one-third to a friend (29%). Higher stress was associated with younger age, lower income, higher education, partner/spouse care, personal care provision, longer caregiving hours, and caregiver cognitive impairment. After including the risk and protective factors from HEPM, victimization, social support, and community engagement significantly predicted perceived stress. Findings contribute to emergent research on caregiving in diverse populations.

"Weight of the World" and "I Want Them to Know": Skilled Nursing Facility Administrators' Perspectives on COVID-19 in Research Poems.

COVID-19 has had a drastic, long-lasting impact on skilled nursing facilities (SNFs), forcing communities to continuously adapt to rapidly changing guidelines, restrictions, and challenges. In spring 2020, we conducted a sequential mixed-methods study with administrators of SNFs in the Midwest to understand the experience of administrators, staff, and residents during the pandemic. We collected 60 surveys with open-ended items related to the impact of the pandemic on communities as a whole, staff, and residents. Survey findings informed supplemental interviews with six administrators working in diverse regions. Due to the affective nature of the data, we present the findings in two found poems, which emphasize the lyrical, emotional, and poignant aspects of the participant voices. The first poem, Weight of the World, captures the struggle to adapt during the transition into the pandemic and its negative impacts on the lives of residents and their families. The second, I Want Them to Know, describes the resiliency with which administrators and staff responded to adversity while maintaining motivation to continue the work in the midst of unprecedented challenges. The two poems offer contrasting or balancing narratives of struggle and survival during the pandemic era.

Key Determinants of Physical and Psychological Health-Related Quality of Life Over Time Among Midlife and Older LGBTQ and Sexual and Gender-Diverse Caregivers.

BACKGROUND AND OBJECTIVES: Prior research has shown informal caregiving among older adults can negatively affect the caregiver's physical and psychological health. However, little is known about protective and risk factors associated with the health-related quality of life (HRQOL) of lesbian, gay, bisexual, transgender, and queer (LGBTQ) caregivers. RESEARCH DESIGN AND METHODS: Informed by the Health Equity Promotion Model and Caregiver Stress Process Model and utilizing longitudinal data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study, this analysis examined modifiable risk and protective factors associated with psychological and physical HRQOL over time among 754 LGBTQ caregivers aged 50-98. RESULTS: Psychological and physical HRQOL declined over a 3-year period. After controlling for background characteristics, mastery, social support, socialization, LGBTQ community engagement, and physical activity were positively associated with psychological HRQOL while day-to-day discrimination, identity stigma, and insufficient food intake were negatively associated. Steeper declines were observed for older and with no physical activity. Mastery, social support, socialization, and physical activity were positively associated with physical HRQOL while day-to-day discrimination and insufficient food intake were negatively associated. Steeper declines were found for those with high mastery and no physical activity. DISCUSSION AND IMPLICATIONS: Although generalized factors including mastery, socialization, and social support are protective for HRQOL among LGBTQ caregivers, factors including day-to-day discrimination and identity stigma are more unique to historically disadvantaged populations and should be considered in future research and practice. Caregiving interventions incorporating physical activity are promising given its buffering effect for decreased physical and psychological HRQOL over time.

Representations of older adults in COVID-related newspaper articles: A comparison between the perspectives of older and younger adults.

During the COVID-19 pandemic, media sources discussed diverse perspectives on aging and older adults, providing opportunities to examine representations of older adults during times of crisis. This study aims to explore representations of older adults during the first month of the pandemic in the U.S. by comparing the perspectives of older and younger adults in national newspapers. A systematic search identified 115 articles published in four major newspapers in the U.S. between March 11 and April 10, 2020, in which older and younger adults were quoted on topics related to the intersection of COVID-19 and aging. Quotes were inductively reviewed using content and thematic analytic strategies. A total of 265 quotes were identified from older adults (n = 104, 39%) and younger adults (n = 161, 61%). We identified three primary themes: impacts on "vulnerable" older adults, debates over the value of older adults' lives, and a counternarrative of resiliency. Older adults were represented as a vulnerable group during the pandemic, in need of protection and support, while debates over the value of their lives similarly evoke images of frailty and dependency. Such depictions frame older adults as a burden on society and reduce their agency and subjectivity. Ageist biases were not only present in quotes from public figures and professionals, but also evident in quotes from older adults themselves. However, older adults also spoke to their own resiliency, survival, and strengths, thereby positioning themselves as elders worthy of respect and able to share wisdom with younger generations. These findings highlight the importance of listening to older adults' voices in order to understand their experiences from their own perspectives through their own agentive positioning and promoting intentionally age-positive and nuanced representations of older adults in public discourse.

Sexual Expression, Policies, and Practices in Skilled Nursing Settings Serving Older Adults: An Updated Assessment in the State of Kansas.

Doll assessed sexual expressions, policies, and practices in Skilled Nursing Facilities (SNFs) in the state of Kansas. This study provided an updated and expanded assessment. A mixed-methods survey was distributed to administrators of all SNFs in the state of Kansas. Among 60 administrations, 84% reported any sexual expression among residents in their community within the past year and 55% reported expressions involving an individual with cognitive impairment. In response to sexual expressions, 70% of administrators believe staff would treat residents with dignity and respect and about 40% anticipated staff discomfort. About 40% of administrators reported having a policy related to sexual expression. Attitudes and responses of staff and administrators appear to be shifting in a sex-positive direction. While policies related to sexuality are more common than a decade ago, there is room for additional uptake, standardization, and infusion of person-centered language and practices.

Historical and generational forces in the Iridescent Life Course of bisexual women, men, and gender diverse older adults.

Purpose: Little is known about the life course of bisexual older adults. This study examines life events and experiences of bisexuals by generation: Pride Generation, born 1950-1964; Silenced Generation, born 1935-1949; and Invisible Generation, born 1934 or earlier, as well as by gender among women, men, and gender diverse older adults. Methods: Aging with Pride: National Health, Aging, and Sexuality/Gender Study is the first national longitudinal study of LGBTQ older adults in the US. We utilize the Iridescent Life Course to examine the life events and life course experiences of bisexual older adults (N = 216) using 2014 survey data. The Iridescent Life Course frames this study for comparing generational and gender differences in five key areas: identity development; work; kin and social relationships; bias-related experiences; and physical and mental health. Findings: The Invisible Generation, the oldest generation, compared to the two younger generations, reports significant risks related to social relationships, the lowest levels of openly disclosing, and fewer bias-related experiences. They also demonstrate important signs of resilience and better mental health. Bisexual men and gender diverse older adults report higher rates of bias-related experiences and fewer social resources than bisexual women. Conclusion: Based on the Iridescent Life Course, we document important differences in the heterogeneity and intersectionality in bisexual lives, particularly for those in late life and those gender diverse. It is essential to document the distinct nature of bisexuals' life course, as it provides both historical and contemporary insights into aging and the reframing of future research.

"Thanks for hearing me out": Voices of social work students during COVID-19.

As social work educators and students, the COVID-19 pandemic impacted our teaching and learning in challenging ways. We embarked on a qualitative research study to better understand the ways in which the pandemic was affecting the social work students in our program. Three faculty mentors worked collaboratively with five social work students across BSW, MSW, and PhD programs to interview 66 BSW and MSW students about their experiences, challenges, and hopes during the early months of the pandemic. BSW and MSW students led the analysis and early dissemination for the project. This essay describes the unique experiences of social work students by using a research poem to capture the emotional and experiential aspects of the students we interviewed.

Ageism in COVID-Related Newspaper Coverage: The First Month of a Pandemic.

OBJECTIVES: Media sources have consistently described older adults as a medically vulnerable population during the coronavirus disease 2019 (COVID-19) pandemic, yet a lack of concern over their health and safety has resulted in dismissal and devaluation. This unprecedented situation highlights ongoing societal ageism and its manifestations in public discourse. This analysis asks how national news sources performed explicit and implicit ageism during the first month of the pandemic. METHOD: Using content and critical discourse analysis methods, we analyzed 287 articles concerning older adults and COVID-19 published between March 11 and April 10, 2020, in 4 major U.S.-based newspapers. RESULTS: Findings indicate that while ageism was rarely discussed explicitly, ageist bias was evident in implicit reporting patterns (e.g., frequent use of the term "elderly," portrayals of older adults as "vulnerable"). Infection and death rates and institutionalized care were among the most commonly reported topics, providing a limited portrait of aging during the pandemic. The older "survivor" narrative offers a positive alternative by suggesting exceptional examples of resilience and grit. However, the survivor narrative may also implicitly place blame on those unable to survive or thrive in later life. DISCUSSION: This study provides insight for policy makers, researchers, and practitioners exploring societal perceptions of older adults and how these perceptions are disseminated and maintained by the media.

How Intimate Partner Violence and Intersectional Identities Converge to Influence Women's Sexual Health across Environmental Contexts.

In this qualitative study, authors examine women's sexual risk and protective factors based on their experiences of intimate partner violence (IPV) and positioning within society relative to power. This analysis examines sexual risk and protective factors across intersectional identities-including gender, race, socioeconomic conditions, and age-among women survivors of IPV. The sample (N = 28) included women of diverse ages (range = 22-60 years) and races (57 percent White, 14 percent African American, 11 percent Hispanic, 7 percent Native American, 7 percent multiracial, and 4 percent South Asian). Findings demonstrated that IPV experiences differentially affect women's sexual health according to intersectional identities and across various levels of environmental context by influencing the (in)stability of their lives and their experiences of (dis)empowerment. This analysis offers a nuanced understanding of how social workers can support women in planning for their own sexual health and safety and shows how an intersectional feminist framework enriches our understanding of the grand challenge to "build healthy relationships to end violence."

Experiences of Palliative and End-of-Life Care among Older LGBTQ Women: A Review of Current Literature.

Background: Understanding end-of-life (EOL) and palliative care continues to grow. However, little attention has been paid to the experiences, preferences, and needs of older lesbian, gay, bisexual, transgender, and queer (LGBTQ) women. While some universal expectations or preferences at EOL exist, this population may not receive adequate or appropriate attention or reporting of unique EOL issues and experiences. Objective: Systematically search for and narratively review existing evidence concerning the expectations, preferences, and needs for palliative and EOL care of LGBTQ older women. Design: A comprehensive literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles reporting needs, experiences, and perspectives of palliative care and EOL care among LGBTQ older women were evaluated. Measurements: Articles published between 1996 and 2019 were retrieved from PsycINFO, MEDLINE, Cochrane Library, Academic Search Complete, AgeLine, CINHAL, PubMed, LGBT Life, SocINDEX, Women's Studies International, Joanna Briggs Institute, and Open Grey. Results: A total of 16 articles were included. Articles described several concerns for the overall LGBTQ population; however, additional issues and experiences specific to older LGBTQ women were also identified, including vulnerability associated with isolation and poverty, women's social needs and support networks, and preferences for complementary care. Conclusion: There remains a need for further research with older LGBTQ women concerning palliative and EOL care, particularly around preparation for EOL and preferences for support. Inclusion of diverse populations in terms of sexual and gender identification are needed to fully understand how to provide appropriate and preferred support.

"You'll See": Younger Women Interviewing Older Women in Qualitative Research.

Understanding the co-construction of the interview process between older adult research participants and relatively younger interviewers requires a nuanced analysis of positioning, reflexivity, and power within interviewing dynamics, accounting for differences in historical context and lived experience. Guided by a feminist life span approach, this study examined interviewing dynamics between a younger woman interviewer and older women research participants, ages 57-93 (mean = 65.3), in two qualitative studies completed five years apart. Four themes emerged: 1) contrasting experiences drew explicit attention to discrepancies in historical context, age, and life experience between participants and the interviewer. Similarities often arose in the theme of 2) invoking expertise in which participants oriented to or invoked their own expertise in their life story and experiences and the interviewer's expertise in research, sexuality studies, and social services. Participants enacted 3) demonstrating care, by prioritizing the researcher's goals, offering advice, and expressing hopes for younger generations. Finally, 4) the participants and researcher used distinctive conversational strategies when addressing challenging or sensitive topics. This paper contributes a needed analysis of age-related dynamics in qualitative research as well as indicating potential strategies to inform reflexive cross-generational conversations in gerontological research and practice more broadly.

"It feels like home": Transgender youth in the Midwest and conceptualizations of community climate.

Community climate toward sexual and gender minority (SGM) youth is associated with higher rates of victimization and poorer health and wellbeing-related outcomes such as depression and suicidal ideation. However, this field of research has underemphasized the experiences of transgender youth, particularly within the Midwestern context which is marked by vast rurality and characterized as sociopolitically conservative. Using qualitative and community-based methods, this study identified factors that impact community climate from the perspective of transgender youth (n = 19) in the Midwest and situated them within the Ecological Systems Theory (EST). Thematic analysis of interviews revealed four themes: resources, visibility, policies, and ideologies. Themes often crossed levels within the EST, indicating the complexity and interrelated nature of climate across local, regional, and national contexts. Implications for theory, research, and practice are discussed.

Iridescent Life Course: LGBTQ Aging Research and Blueprint for the Future - A Systematic Review.

BACKGROUND: LGBTQ* (lesbian, gay, bisexual, trans, and queer) older adults are demographically diverse and growing populations. In an earlier 25-year review of the literature on sexual orientation and aging, we identified four waves of research that addressed dispelling negative stereotypes, psychosocial adjustment to aging, identity development, and social and community-based support in the lives of LGBTQ older adults. OBJECTIVES: The current review was designed to develop an evidence base for the field of LGBTQ aging as well as to assess the strengths and limitations of the existing research and to articulate a blueprint for future research. METHODS: Using a life course framework, we applied a systematic narrative analysis of research on LGBTQ aging. The review included 66 empirical peer-reviewed journal articles (2009-2016) focusing on LGBTQ adults aged 50 years and older, as well as age-based comparisons (50 years and older with those younger). RESULTS: A recent wave of research on the health and well-being of LGBTQ older adults was identified. Since the prior review, the field has grown rapidly. Several findings were salient, including the increas-ed application of theory (with critical theories most often used) and more varied research designs and methods. While -existing life course theory provided a structure for the investigation of the social dimensions of LGBTQ aging, it was limited in its attention to intersectionality and the psychological, behavioral, and biological work emerging in the field. There were few studies addressing the oldest in these -communities, bisexuals, gender non-binary older adults, intersex, -older adults of color, and those living in poverty. -Conclusions: The Iridescent Life Course framework highlights the interplay of light and environment, creating dynamic and fluid colors as perceived from different angles and perspectives over time. Such an approach incorporates both queering and trans-forming the life course, capturing intersectionality, fluidity over time, and the psychological, behavioral, and biological as well as social dimensions of LGBTQ aging. Work is needed that investigates trauma, differing configurations of risks and resources over the life course, inequities and opportunities in representation and capital as LGBTQ adults age, and greater attention to subgroups that remain largely invisible in existing research. More depth than breadth is imperative for the field, and multilevel, longitudinal, and global initiatives are needed.