Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T03:05:33.692Z Has data issue: false hasContentIssue false
  • English
  • Français

The barriers and enablers to service access for older women living alone in Australia

Published online by Cambridge University Press:  24 September 2020

Marissa Dickins Open the ORCID record for Marissa Dickins [Opens in a new window] ,
Georgina Johnstone Open the ORCID record for Georgina Johnstone [Opens in a new window] ,
Emma Renehan ,
Judy Lowthian  and
Rajna Ogrin Open the ORCID record for Rajna Ogrin [Opens in a new window]
Marissa Dickins*
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia Southern Synergy, Department of Psychiatry at Monash Health, Southern Clinical School, Monash University, Melbourne, Australia
Georgina Johnstone
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia
Emma Renehan
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia Beyond Blue, Hawthorn, Melbourne, Australia
Judy Lowthian
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia Institute of Future Environments, Queensland University of Technology, Brisbane, Australia
Rajna Ogrin
Affiliation:
Bolton Clarke Research Institute, Melbourne, Australia Department of International Business and Asian Studies, Griffith University, Brisbane, Australia Biosignals for Affordable Healthcare, RMIT University, Melbourne, Australia Austin Health Department of Medicine, University of Melbourne, Melbourne, Australia
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Older women living alone are at risk of being socially and financially disadvantaged, which impacts their wellbeing. Currently there is a significant gap in knowledge relating to older women living alone. This study aimed to identify the barriers and enablers to service access in this group. We undertook a qualitative study comprising semi-structured interviews in metropolitan Melbourne, Australia. Thematic analysis was conducted to elucidate key themes. Thirty-seven women were interviewed between May and August 2017. Six key themes were identified: financial; mental and emotional health; mobility and ability; transport; social connections; and knowledge. Access issues for older women living alone are multifaceted and interconnected. Barriers and enablers to service access, as well as their intersections with gender and living situation, should be considered in service design and re-design.

Keywords

womenqualitative research methodssocial servicesinequity
Type
Article
Information
Ageing & Society , Volume 42 , Issue 4 , April 2022 , pp. 849 - 867
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andonian, L and MacRae, A (2011) Well older adults within an urban context: strategies to create and maintain social participation. British Journal of Occupational Therapy 74, 2–11.10.4276/030802211X12947686093486CrossRefGoogle Scholar
Arnold, E, Bruton, A and Ellis-Hill, C (2006) Adherence to pulmonary rehabilitation: a qualitative study. Respiratory Medicine 100, 1716–1723.10.1016/j.rmed.2006.02.007CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics (2013) IRSD (2033.0.55.001). Canberra: Australian Bureau of Statistics.Google Scholar
Australian Bureau of Statistics (2015) Household and Family Projections, Australia, 2011 to 2036. Canberra: Australian Bureau of Statistics.Google Scholar
Australian Bureau of Statistics (2017) Census of Population and Housing: Reflecting Australia – Stories from the Census, 2016. Canberra: Australian Bureau of Statistics.Google Scholar
Australian Institute of Health and Welfare (2013) The Desire to Age in Place Among Older Australians. Canberra: Australian Institute of Health and Welfare.Google Scholar
Bacsu, J, Jeffery, B, Novik, N, Abonyi, S, Oosman, S, Johnson, S and Martz, D (2014) Policy, community and kin: interventions that support rural healthy aging. Activities, Adaptation & Aging 38, 138–155.Google Scholar
Banister, D and Bowling, A (2004) Quality of life for the elderly: the transport dimension. Transport Policy 11, 105–115.10.1016/S0967-070X(03)00052-0CrossRefGoogle Scholar
Boneham, MA, Williams, KE, Copeland, JRM, McKibbin, P, Wilson, K, Scott, A and Saunders, PA (1997) Elderly people from ethnic minorities in Liverpool: mental illness, unmet need and barriers to service use. Health and Social Care in the Community 5, 173–180.10.1111/j.1365-2524.1997.tb00112.xCrossRefGoogle Scholar
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 71–101. doi:10.1191/1478088706qp063oa.CrossRefGoogle Scholar
Buttery, AK, Carr-White, G, Martin, FC, Glaser, K and Lowton, K (2014) Cardiac rehabilitation for heart failure: do older people want to attend and are they referred? European Geriatric Medicine 5, 246–251.10.1016/j.eurger.2014.04.011CrossRefGoogle Scholar
Chappell, NL, Dlitt, BH, Hollander, MJ, Miller, JA and McWilliam, C (2004) Comparative costs of home care and residential care. The Gerontologist 44, 389–400.10.1093/geront/44.3.389CrossRefGoogle ScholarPubMed
Cheng, S-T, Fung, HH and Chan, ACM (2008) Living status and psychological well-being: social comparison as a moderator in later life. Aging & Mental Health 12, 654–661.10.1080/13607860802343241CrossRefGoogle ScholarPubMed
Coelho, J and Duarte, C (2015) Socially networked or isolated? Differentiating older adults and the role of tablets and television. In Abascal, J, Barbosa, S, Fetter, M, Gross, T, Palanque, P and Winckler, M (eds), Human–Computer Interaction – INTERACT 2015. Cham, Switzerland: Springer International, pp. 129–146.10.1007/978-3-319-22701-6_10CrossRefGoogle Scholar
Cohen-Mansfield, J and Perach, R (2015) Interventions for alleviating loneliness among older persons: a critical review. American Journal of Health Promotion 29, e109–e125.10.4278/ajhp.130418-LIT-182CrossRefGoogle ScholarPubMed
Courtney, KL, Demiris, G, Rantz, M and Skubic, M (2008) Needing smart home technologies: the perspectives of older adults in continuing care retirement communities. Informatics in Primary Care 16, 195–201.Google ScholarPubMed
Cresci, MK, Yarandi, HN and Morrell, RW (2010) Pro-Nets versus No-Nets: differences in urban older adults’ predilections for Internet use. Educational Gerontology 36, 500–520.10.1080/03601270903212476CrossRefGoogle Scholar
Delaney, L (2018) Patient-centred care as an approach to improving health care in Australia. Collegian 25, 119–123.10.1016/j.colegn.2017.02.005CrossRefGoogle Scholar
De San Miguel, K, Lewin, G, Burton, E, Toye, C, Boldy, D and Howat, P (2015) Exploring risk profiles and emergency frequency of purchasers and non-purchasers of personal emergency alarms: a prospective cohort study. BMC Geriatrics 15, article number, 140.10.1186/s12877-015-0139-4CrossRefGoogle ScholarPubMed
de Vaus, D and Qu, L (2015 a) Demographics of Living Alone. Melbourne: Australian Institute of Family Studies.Google Scholar
de Vaus, D and Qu, L (2015 b) Living Alone and Personal Wellbeing. Melbourne: Australian Institute of Family Studies.Google Scholar
Dickins, M, Joe, A, Enticott, J, Ogrin, R and Lowthian, J (in press) Trajectories of home nursing use for older women in Melbourne, Australia: 2006–2015. Australasian Journal on Ageing doi:10.1111/ajag.12735.Google Scholar
Dow, B, Sparrow, P, Moore, K, Gaffy, E and Yates, I (2013) What do older Australians want? Australasian Journal on Ageing 32, 236–240.10.1111/ajag.12040CrossRefGoogle ScholarPubMed
Dreyer, K, Steventon, A, Fisher, R and Deeny, SR (2018) The association between living alone and health care utilisation in older adults: a retrospective cohort study of electronic health records from a London general practice. BMC Geriatrics 18, 269.10.1186/s12877-018-0939-4CrossRefGoogle ScholarPubMed
Feldman, S and Radermacher, H (2016) Time of Our Lives? Building Opportunity and Capacity for the Economic and Social Participation of Older Australian Women. Melbourne: Lord Mayor's Charitable Foundation.Google Scholar
Gabrielson, ML (2011) ‘We have to create family’: aging support issues and needs among older lesbians. Journal of Gay & Lesbian Social Services 23, 322–334.10.1080/10538720.2011.562803CrossRefGoogle Scholar
Gaugler, JE and Zarit, SH (2001) The effectiveness of adult day services for disabled older people. Journal of Aging & Social Policy 12, 23–47.10.1300/J031v12n02_03CrossRefGoogle ScholarPubMed
Goins, RT, Williams, KA, Carter, MW, Spencer, SM and Solovieva, T (2005) Perceived barriers to health care access among rural older adults: a qualitative study. Journal of Rural Health 21, 206–213.10.1111/j.1748-0361.2005.tb00084.xCrossRefGoogle ScholarPubMed
Greaves, M and Rogers-Clark, C (2009) The experience of socially isolated older people in accessing and navigating the health care system. Australian Journal of Advanced Nursing 27, 5–11.Google Scholar
Henning-Smith, C and Gonzales, G (2020) The relationship between living alone and self-rated health varies by age: evidence from the National Health Interview Survey. Journal of Applied Gerontology 39, 971–980.10.1177/0733464819835113CrossRefGoogle ScholarPubMed
Hlebec, V (2014) Individual and contextual determinants of social homecare usage in Slovenia. Zdravstveno Varstvo 53, 311–317.Google ScholarPubMed
Hodge, H, Carson, D, Carson, D, Newman, L and Garrett, J (2017) Using Internet technologies in rural communities to access services: the views of older people and service providers. Journal of Rural Studies 54, 469–478.10.1016/j.jrurstud.2016.06.016CrossRefGoogle Scholar
Joe, A, Dickins, M, Enticott, J, Ogrin, R and Lowthian, J (2020) Community-dwelling older women: the association between living alone and use of a home nursing service. Journal of the American Medical Directors Association 21, 1273–1281.e2.10.1016/j.jamda.2019.11.007CrossRefGoogle ScholarPubMed
Kharicha, K, Iliffe, S, Harari, D, Swift, C, Gillmann, G and Stuck, AE (2007) Health risk appraisal in older people 1: are older people living alone an ‘at-risk’ group? British Journal of General Practice 57, 271–276.Google Scholar
Lau, DT, Machizawa, S and Doi, M (2012) Informal and formal support among community-dwelling Japanese American elders living alone in Chicagoland: an in-depth qualitative study. Journal of Cross-cultural Gerontology 27, 149–161.10.1007/s10823-012-9166-1CrossRefGoogle Scholar
Levine, ME and Crimmins, EM (2018) Is 60 the new 50? Examining changes in biological age over the past two decades. Demography 55, 387–402.10.1007/s13524-017-0644-5CrossRefGoogle ScholarPubMed
Lucas, RE (2007) Adaptation and the set-point model of subjective well-being: does happiness change after major life events? Current Directions in Psychological Science 16, 75–79.10.1111/j.1467-8721.2007.00479.xCrossRefGoogle Scholar
Mahoney, DF, Mahoney, EL and Liss, E (2009) AT EASE: Automated Technology for Elder Assessment, Safety, and Environmental monitoring. Gerontechnology 8, 11–25.10.4017/gt.2009.08.01.003.00CrossRefGoogle Scholar
Morris, A, Barnes, J and Fildes, B (2018) Challenges of using the bus as an older person. WIT Transactions on the Built Environment 176, 539–544. doi: 10.2495/UT170461.Google Scholar
National Association of Area Agencies on Aging, National Council on Aging and UnitedHealthcare (2015) The United States of Aging Survey. Washington D.C.: National Council on Ageing.Google Scholar
Nelms, L, Johnson, V, Teshuva, K, Foreman, P and Stanley, J (2009) Social and health factors affecting community service use by vulnerable older people. Australian Social Work 62, 507–524.10.1080/03124070903312823CrossRefGoogle Scholar
Ofei-Dodoo, S, Medvene, LJ, Nilsen, KM, Smith, RA and DiLollo, A (2015) Exploring the potential of computers to enrich home and community-based services clients’ social networks. Educational Gerontology 41, 216–225.10.1080/03601277.2014.950491CrossRefGoogle Scholar
Orellano-Colón, EM, Mountain, GA, Rosario, M, Colón, ZM, Acevedo, S and Tirado, J (2015) Environmental restrictors to occupational participation in old age: exploring differences across gender in Puerto Rico. International Journal of Environmental Research and Public Health 12, 11288–11303.10.3390/ijerph120911288CrossRefGoogle ScholarPubMed
Redfoot, D, Feinberg, L and Houser, A (2013) The Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in the Availability of Family Caregivers. Washington, DC.: American Association of Retired Persons.Google Scholar
Salganicoff, A, Cubanski, J, Ranji, U and Neuman, T (2009) Health coverage and expenses: impact on older women's economic well-being. Journal of Women, Politics & Policy 30, 222–247.10.1080/15544770902901874CrossRefGoogle Scholar
Sandelowski, M (2000) Whatever happened to qualitative description? Research in Nursing & Health 23, 334–340.10.1002/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Saurman, E (2015) Improving access: modifying Penchansky and Thomas's Theory of Access. Journal of Health Services Research & Policy 21, 36–39.10.1177/1355819615600001CrossRefGoogle ScholarPubMed
Tong, A, Craig, J and Sainsbury, P (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care 19, 349–357.10.1093/intqhc/mzm042CrossRefGoogle ScholarPubMed
Tsai, L-T, Rantakokko, M, Portegijs, E, Viljanen, A, Saajanaho, M, Eronen, J and Rantanen, T (2013) Environmental mobility barriers and walking for errands among older people who live alone vs. with others. BMC Public Health 13, 1054.10.1186/1471-2458-13-1054CrossRefGoogle Scholar
United Nations Department of Economic and Social Affairs, Population Division (2017 a) Living Arrangements of Older Persons: A Report on an Expanded International Dataset. New York, NY: United Nations Department of Economic and Social Affairs, Population Division.Google Scholar
United Nations Department of Economic and Social Affairs, Population Division (2017 b) World Population Prospects: Key Findings and Advance Tables. New York, NY: United Nations Department of Economic and Social Affairs, Population Division.Google Scholar
Vozikaki, M, Linardakis, M and Philalithis, A (2017) Preventive health services utilization in relation to social isolation in older adults. Journal of Public Health 25, 545–556.10.1007/s10389-017-0815-2CrossRefGoogle Scholar
Weddle, DL (2012) Predisposing, enabling and need characteristics that influence older African Americans’ use of congregate meal services. Dissertation Abstracts International Section A: Humanities and Social Sciences 72, 3333.Google Scholar
Weissman, JD and Russell, D (2016) Relationships between living arrangements and health status among older adults in the United States, 2009–2014: findings from the National Health Interview Survey. Journal of Applied Gerontology 37, 7–25.10.1177/0733464816655439CrossRefGoogle ScholarPubMed