Casino gambling among urban elders: just another social activity?

OBJECTIVES: This study explored older adults' attitudes about a range of activities and determined characteristics associated with casino participation. Activity theory was used as conceptual framework to examine casino gambling as a newer social activity and to identify characteristics related to gambling behavior among elders. METHODS: The sample consisted of 1,410 randomly selected participants, aged 60 and older, who reside in the city of Detroit. Through the use of a cross-sectional analyses, selected variables tested with casino visits included health, demographics, social activities, senior optimism, opinions about casinos, transportation, and social support network. RESULTS: Bivariate associations revealed that sociodemographic variables such as income, age, education, marriage, and transportation were significantly associated with casino participation. Additional factors associated with casino visitation included positive attitudes about casinos, social support network, and enjoying a variety of other "active" activities. DISCUSSION: The results of this study supported the theoretical perspective underlying the basis of this project. Although not a favorite activity, gambling is among several types of social activities in which older adults do participate. Results suggest further investigation of how casino activities relate to mental health and other leisure activities.

Complementary and alternative medicine use among a multiethnic sample of older adults with diabetes.

OBJECTIVE: This study describes complementary and alternative medicine (CAM) use for diabetes self-management among a multiethnic sample with an aim of better understanding lay perspectives on CAM's utility and determining whether CAM practices undermine conventional diabetes self-management. DESIGN: During in-depth interviews with 80 older adults, data were collected on sociodemographics, the full range of self-management practices, and attitudes toward CAM. Analysis included descriptive measures of association and line-by-line coding. SETTING/LOCATION: Trained interviewers recruited respondents from four health or social service sites. Sites were selected because they contained a large clientele of the targeted ethnic group and had been involved successfully in previous research studies. SUBJECTS: Twenty (20) adults age 50 and older from each of the groups most adversely affected by diabetes (African Americans, Hispanics, Native Americans, rural whites) participated in the study. OUTCOME MEASURES: Self-management strategies (included CAM) were assessed through a semistructured interview guide. Structured instruments obtained data on sociodemographics and health history. The 15-item Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) assessed the frequency of completing recommended self-management activities. RESULTS: One in four elders reported using CAM, with respondents' cultural background associated with the CAM modality. We found no relationship between standard biomedical regimens and CAM use, supporting respondents' suggestion that CAM supplements rather than substitutes for biomedical self-management. Respondents suggested that use of CAM was limited by CAM's inaccessibility, and, underlying all, the dominance of conventional biomedical therapies that undermines belief in CAM's effectiveness. CONCLUSION: Older adults with diabetes use a flexible configuration of diabetes-self-management techniques, including culturally specific CAM modalities. CAM use, however, occupies a limited role in diabetes self-management, largely because of the predominance of conventional biomedical regimens.

Long-term care preferences and attitudes among Great Lakes American Indian families: cultural context matters.

This research examines the role of family and culture in planning for future long-term care needs and preferences among 252 elders age 55 and older and 74 middle generation children of Great Lakes American Indians living in three residential areas: urban, reservation, and off-reservation rural. Findings show that both generations prefer a non-institutional home-based choice for care if needed, and that acculturation levels influence those choices. Level of acculturation differed by area of residence.