Social Participation During Transition to Adult Life Among Young Adults With High-Functioning Autism Spectrum Disorders: Experiences From an Exploratory Multiple Case Study

This study aimed to explore the social participation of young adults with high-functioning autism spectrum disorders (HFASD) during their transition to adult life. A multiple case study was conducted using semi-structured interviews with a purposive sample of 10 participants (n = 10) composed of three adults with HFASD, their caregivers, and two representatives of community organizations. Four themes emerged: (1) access to services, (2) orientation to integrated life goals, (3) engagement in meaningful activities, and (4) gap in services before reaching independent living. Properly preparing and orienting the families could help them have a more satisfying social participation.     

“I Am Just an Ordinary Person …”: Spiritual Reminiscence in Older People with Memory Loss

SUMMARY

One of the greatest challenges to people diagnosed with dementia is their search for meaning leading to the development of effective coping strategies as their memory loss and confusion progresses. The challenge for carers is to learn ways of entering the world of people who have difficulties communicating and have behaviour problems, assisting them to communicate more effectively by responding to their interests and needs, and listening to their emotions expressed in various ways. Strategies are being developed for supporting and affirming personhood in those people who are often isolated and withdrawn from even their closest friends and relatives. Spiritual reminiscence work is one way of helping older people with memory loss find meaning in their lives as they cope with the day to day difficulties of memory loss and prepare for death.

This paper will present the results from indepth interviews from 16 participants in a larger study exploring memory loss and spiritual reminiscence. Themes arising from the data analysis revolve around notions of relationships, loneliness, family and attendance at worship.     

How the “Not Religious” Experience and Witness Suffering and Death: Case Studies

ABSTRACT

This article is based on a subset of a multi-site (8), multi-year (4) research study that explored the cultural construction of dying and death in long-term care facilities. In open-ended interviews with residents and staff members, we learned how four individuals who describe themselves as “not religious” respond to queries about the meaning of suffering and death while working and living in long-term care.

We present case studies of two residents and two staff members from one of the sites–a secular, for-profit nursing home–who described themselves as not religious. We offer a brief history of their lives and daily activities, and present their responses to our queries about dying and death.

A finding of this article is that the nonreligious residents and staff members discussed here found significance in personal meaning systems developed through past, positive life events and present uncertainty about suffering and death. The self-described “not religious” provide another perspective on facing the end of life.     

POETRY

ABSTRACT

This article presents a pilot project in which reminiscence group members read mystics from several religious traditions to select imagery about the mystical theme of an unconditionally accepted “Core Self.” The perspective from “Core Self,” in turn, reframes unforgiving judgments some members have made about their personal history, ameliorates meager levels of self-esteem through which they have reviewed their life, and draws from their reminiscences more functional ways of managing current issues. The article concludes with examples of members offering additional insights into the life review of three colleagues that enhance the benefits of the project.     

The Spiritual Dimension of Caring: Applying a Model for Spiritual Tasks of Ageing

SUMMARY

This chapter describes a spiritual dimension of ageing using themes and a model for spiritual tasks of ageing, developed as a part of doctoral studies that examined spirituality amongst a group of independent-living older adults in Canberra and NSW. This model has been tested further and the model was confirmed through in-depth interviews of residents of nursing homes in the ACT. The first study identified six major spiritual themes from participant interviews. These were: ultimate meaning in life for each person, the way they responded to meaning, self-sufficiency versus despair, moving from provisional to final life meanings, relationship versus isolation in ageing and hope versus despair.     

The Importance of Religious Orientation and Purpose in Life for Dying Well: Evidence from Three Case Studies

ABSTRACT

As older adults approach the end of their lives, it is not uncommon to find a decrease in subjective well-being. However, a number of studies have indicated that elders with an intrinsic rather than extrinsic religious orientation often are able to keep a high level of subjective well-being even if they are close to death. In a previous quantitative study, only intrinsic religiosity was indirectly and positively related to subjective well-being in a sample of 103 relatively healthy older adults and 19 hospice patients (aged 61 +), mediated by shared spiritual activities and purpose in life. Extrinsic religiosity, by contrast, was indirectly and negatively related to subjective well-being. To explore in greater depth how religious orientation might influence subjective well-being at the end of life, we used the method of objective hermeneutics to examine semi-structured qualitative interviews with three older male hospice patients (aged 79, 80, and 98) on religion/spirituality and attitudes about death and dying. Results of the analyses revealed that the intrinsically religious respondent maintained his sense of cosmic purpose in life, which continued to be a source of satisfaction for him, unaffected by his terminal illness. The two extrinsically religious respondents, however, did not find solace in their religion and, hence, were unable to cope with their physical and emotional dependence and vulnerability. The findings suggest that an intrinsic religious orientation is most likely to be related to a cosmic sense of purpose in life, which facilitates subjective well-being even in the face of death.     

Dementia and Suffering in Nursing Homes

SUMMARY

This paper uses case studies of challenging behaviour associated with dementia to demonstrate, firstly, that disturbed behaviour is often a manifestation of suffering caused by multiple phenomena such as medical problems or the care environment. Addressing these causes instead of simplistically ‘treating the behaviour’ usually reduces the behaviour. Secondly, staff distress with a particular difficult resident is often caused by more general fundamental problems such as a lack of support or knowledge. Addressing these problems reduces staff distress. Finally, results from a Swedish intervention study are presented. They show that suffering for both staff and residents can be reduced, and quality of life improved, by providing increased autonomy for hands-on staff, systematic emotional support, and collaboratively developing care plans based on each resident's emotional and physical needs, rather than the problems they present.     

Religiosity and Church-Based Assistance Among Chronically Ill African-American and White Elderly

ABSTRACT

This study examines religion and church-based assistance among 127 chronically ill African-American and white elderly persons hospitalized for congestive heart failure and discharged to home. Elders reported high levels of religiosity and prayer behavior; they reported low levels of church help received. Controlling for living arrangement, gender, social class and health in probit regression analyses, race was not a significant predictor of subjective religiosity, frequency of prayer, or level of church help received. Findings indicated a significant race-by-health interaction. Subjective religiosity was positively associated with health for whites but no relationship was found between religiosity and health for African-Americans. Further research is called for that replicates study findings on other elders with chronic illness.     

Development and Initial Psychometric Evaluation of the Transgender Adaptation and Integration Measure (TG AIM)

ABSTRACT

Transgender individuals have a gender identity or expression that is not congruent with their anatomy (Bullough, 2000). Limited empirical data are available regarding the mental health and general well-being of the transgender population. In addition, few standardized measures have been developed specifically for transgender individuals. The main purpose of this study was item and scale development of a measure of adjustment for transgender adults, as well as the assessment of the internal consistency and validity of the measure. Responses to the Transgender Adaptation and Integration Measure (TG AIM) were collected from a sample of 108 self-identified male-to-female transsexual adults. Standardized measures of quality of life and self-esteem were also administered to participants in order to assess construct-related validity. Factor analysis of the measure identified four factors: Gender-Related Fears, Psychosocial Impact of Gender Status, Coping and Gender Reorientation Efforts, and Gender Locus of Control. Internal consistency for each of the four factors ranged from r = .59 to r = .81. Psychosocial Impact of Gender Status and Gender-Related Fears were positively correlated with self-esteem and quality of life. Coping and Gender Reorientation Efforts were significantly correlated to both Psychosocial Impact of Gender Status and Gender-Related Fears. Preliminary psychometric analysis resulted in a 15 item, multidimensional measure with three reliable and valid subscales for use with male to female (MtF) transsexual adults. Further psychometric evaluation of the measure for use with other segments of the transgender population is needed.