Availability of mental health services for older adults: a cross-cultural comparison of the United States and Turkey

Researchers conducted a cross-cultural study using qualitative methods (based on a phenomenological approach) to explore the availability of mental health services (MHS) for older adults in the United States and Turkey. Using purposive sampling, semi-structured in-depth interviews were conducted with administrators (n=24) from a wide-range of sites (nursing homes, hospice, senior centers) in a rural area of North Central Florida, United States and Ankara, Turkey. Interview questions focused on types of staff employed; integration of MHS with other services provided; community promotion of services; coordination, cooperation and communication with other service providers; and administrators' perceptions of barriers in the provision of MHS for older adults. Interestingly, employing on-site mental health staff was a much more popular practice in Turkey compared to the United States with three times as many Turkish sites having on-site mental health professionals. As anticipated, administrators in both countries cited inadequate funding as the most common barrier to MHS provision. Potential solutions to MHS barriers in both countries are discussed.

When world views collide: a commentary on home health care case-mix and patient outcomes

The Health Care Financing Administration (HCFA) has developed a prospective payment system for home-health care that is primarily focused on cost-containment. This new payment system results in a change in a case-mix for treatment that was more care-outcome based. The new case mix is compared to the old case mix with respect to research that is ignored regarding care outcome.

Age differences in voluntary association memberships: fact or artifact

OBJECTIVES

To determine if the curvilinear relationship between age and voluntary association memberships is due to compositional differences between age groups.

METHODS

Data are drawn from 12 nationally representative surveys covering the period 1974-1994 and including items on membership in 16 types of associations. Age is categorized into 14 groups ranging from 18-24 through 85+. Patterns of age differences in number of association memberships are examined before and after controlling for several variables related both to age and to memberships.

RESULTS

At the bivariate level, number of memberships increases through ages 40-44 and then declines fairly steadily. When controls for compositional differences are introduced, the curvilinear pattern of age differences is replaced by one showing an increasing number of memberships through ages 55-59, a slight decrease in the 60-64 age group, and then generally stable membership levels through the 85+ age group.

DISCUSSION

The lower levels of voluntary association memberships of older persons consistently identified in bivariate analyses appear to be largely due to differences in compositional characteristics between the older and other age groups.