Counseling services for older persons as perceived and provided by selected Florida aging program administrators and dir...

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Title:
Counseling services for older persons as perceived and provided by selected Florida aging program administrators and direct service personnel
Physical Description:
xiv, 226 leaves : map ; 28 cm.
Language:
English
Creator:
Murphey, Milledge, 1940-
Publication Date:

Subjects

Subjects / Keywords:
Social case work with the aged -- Florida   ( lcsh )
Social workers -- Attitudes -- Florida   ( lcsh )
Counselor Education thesis Ph. D
Dissertations, Academic -- Counselor Education -- UF
Genre:
bibliography   ( marcgt )
non-fiction   ( marcgt )

Notes

Thesis:
Thesis--University of Florida.
Bibliography:
Bibliography: leaves 215-224.
Statement of Responsibility:
by Milledge Murphey.
General Note:
Typescript.
General Note:
Vita.

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
aleph - 000091235
oclc - 05871994
notis - AAK6630
System ID:
AA00002201:00001

Full Text

















COUNSELING
PROVIDED BY


SERVICES FOR OLDER PERSONS AS PERCEIVED AND
SELECTED FLORIDA AGING PROGRAM ADMINISTRATORS
AND DIRECT SERVICE PERSONNEL


MILLEDGE MURPHY


A DISSERTATION
THE UNIVERSITY
REQUIREMENTS


PRESENTED TO THE GRADUATE COUNCIL OF
OF FLORIDA IN PARTIAL FULFILLMENT OF
OR THE DEGREE OF DOCTOR OF PHILOSOPHY




































Copyright


Milledge


Murphey


1979


































z4 1bytre Frfael ~t Arch


in 2011 with funding from
University of Florida, George A. Smathers Libraries with support from LYRASIS and the Sloan Foundation


















ACKNOWLEDGEMENTS


want


to thank some of


the many people who


have


assisted me


in completing this


study.


Dr. Harold Riker


been a


personal


friend,


counselor


, pro-


fessional


peer,


professor,


and supporter


of my work in aging


number


years.


As chairman


of my


doctoral


committee,


he spent many


hours working with me


in all facets


of the


program,


with specific and


invaluable assistance


in the design and


completion


of the dissertation.


sincere


appreciation and


gratitude


are extended


to him


for his


guidance.


Having


known me


for a number


years


Robert


Stripling


served as


a doctoral


committee


member


consistently provided me


with guidance


and inspiration when


was


in need.


interest


in me


as a person,


and his


thoughtful


counsel


with me,


will


always


sincerely


Ed.S.


appreciated.

committee in


Dr. James


Educational


L. Wattenbarger was

Administration and h


chairman of


as continued


to give


personal


support


and assistance


to me


at the doctoral


level.


His knowledge


of the broad spectrum of higher


education and


willingness


to assist me with many varied problems


is sincerely


appreciated.

aRn a et*Tn n n


Dr. Hannelore


Wass


has demonstrated


that


scientific


ha no l-,.t.n n-4 n mnIflnnnr^ Un


Ir a nnn rtll A C d~


f, _


I"F


A nr~ n n nn rl


F>











Harold Mitchum,


Hachi-Dan,


Isshinryu Karate,


my Sense,


friend,


time


has provided me


tested


with


perspective.


an understanding


His humble


of life


quiet


from a


example of


unique


strength


with


softness


will


continue


to set the


tone


for my


life--"If


want


to know


something


a short


period


of time


you will


know nothing


good.


am grateful


for the assistance


in the Florida Aging Network.


Especially


of the professional


helpful


was


staff


Dr. June Duggar


of the State


Aging


and Adult


Services


Program


Office


in Tallahassee.


thanks


to E. Bentley


Lips comb,


Director


of the Aging


and Adult


Program


Office,


whose


support


of this


project


enabled


me to have


access


to a wide


variety


of individuals


and records


which would


otherwise


have


been


unavailable


special


appreciation


goes


to the Aging and Adult


Services


Pro-


gram Supervisors


throughout


Florida,


cooperated


with


me in


con-


ducting


the study.


Without


their


assistance,


the study


could not


have


been


accomplished.


supervisors


and workers


of the Specialized


Adult


Services


Units


throughout


Florida,


who,


though


overworked,


under-


paid,


unsung,


not only


aided


in the study,


but continue


to provide


services


for older persons


are in need.


Aging Project


staff


administrative


personnel


are due


my gratitude


for their participation,


and more


importantly,


for the important


services


they


render


to the


elderly

staffs


of Florida.


and especially


gratitude


the District


goes


to the Areawide


ILL A.AA


for their


Agency


support


on Aging

in both


4~ ~~n C ,.me e- -I nn mnr n


me.


t n Fnumn t rl nn










have


been


unable


to equal


terms


of being a


totally valuable


human


being,


of the highest


possible


integrity.


While


he did not


live


see the completion of


this


pursuit,


believe


his example


provided


greatest


share


of motivation


for my


undertaking and


completing


















TABLE


OF CONTENTS


ACKNOWLEDGEMENTS.


LIST


OF TABLES.


ABSTRACT


CHAPTER


INTRODUCTION.


Background


Need for the Study .
Purpose of the Study
Research Questions .


Rationale.
Definition


of Terms


REVIEW


OF THE


LITERATURE.


Characteristics
Persons .


and Needs


Older


Economics, Income
Health Needs and


and Retirement


Characters


tics


Living Arrangements.


. . a 20


Social,


Activity,


Family


Needs


. . .22


Perceptions


Areas


and Attitudes


of Research


Towards


on Attitudes


Aging


Towards


Aging
Attitudes


and the Aged;


Towards


Aging


Instruments


Among


Trainees


Practitioners


and Administrators.


Organization
Services


and Funding


For Older


Counseling


persons


METHODOLOGY


a, an a\ a a


U I.JLU.LUJu UIat..LUJLL .


* a a a a a *
. a a a a .
* . a a


Page












RESULTS


Resulting
Analysis


Sample .
of Questionnaire


SUMMARY, DISCUSSION
AND SUGGESTIONS FOR


Summary. *
Discussion a
Implications
Suggestions


Responses.


AND CONCLUSIONS,
FURTHER RESEARCH.


nd Conclusions .
S S S S *


for Future


IMPLICATIONS,
. . S .


* * *
* * * *
r rO Q
I D


Research


APPENDICES


QUESTIONNAIRE


S S S S S S S S S S S S S S S 160


STANDARDIZED PROCEDURES
QUESTIONNAIRE. *


FOR ADMINISTRATION


FLORIDA AGING PROGRAM JOB DESCRIPTION


FLORIDA AGING AND ADULT
TITLE III
COUNSELING PROJECTS


SUMMARY


SERVICES

1977-78


AGING


ADULT


SERVICES.


S S S S S S S S S 5 9 5180


HRS DIRECT SERVICES
SEPTEMBER 25,


CLASS
1978


STUDY,
* * * * *


CROSSTABULATION OF SAMPLE CHARACTERISTICS:
SUBJECT IN WHICH HIGHEST DEGREE WAS
EARNED BY SEX AND RACE


CROSSTABULATION
EDUCATION


CROSSTABULATION OF
WORK LOCATION


SAMPLE CHARACTERISTIC
SEX AND RACE. .


SAMPLE CHARACTERISTICS
BY SEX AND RACE. .


CROSSTABULATION
EDUCATION


CROSSTABULATION


SAMPLE
SUBJECT


OF SAMPLE


CHARACTERISTICS:
. . S S 5 4 5 5 5


CHARACTERISTICS


Inc


Page










Page


CROSSTABULATION
POSITION BY


OF SAMPLE
AGE AND


CHARACTERISTICS:
SEX. . .


S. . 202


ITEM MEAN
AND


S (AND STANDARD DEVIATIONS)
FEMALES. . .


FOR MALES


ITEM MEANS

ITEM MEANS

ITEM MEANS


(AND

(AND

(AND


STANDARD

STANDARD

STANDARD


DEVIATIONS)

DEVIATIONS)

DEVIATIONS)


FOR EDUCATION.

FOR AGE. .

FOR RACE .


REFERENCES.


BIOGRAPHICAL


S. . . . . . 215


SKETCH


















LIST


OF TABLES


Page


TABLE


LEVEL OF EDUCATION OF TEST RETEST
BY SEX AND RACE. .. .


SAMPLE
. . .


WORK LOCATION OF TEST
BY SEX AND RACE.


RETEST


SAMPLE


MEAN,


STANDARD DEVIATION
CORRELATION COEFFIC


AND T
IENTS


EST RETEST
FOR PILOT TEST.


. . 58


CROSSTABULATION OF TOTAL SAMPLE
LOCATION BY POSITION .


CHARACTERISTICS


SUMMARY


CROSS


OF DEMOGRAPHIC


TABULATION
SEX BY RACE.


CHARACTERISTICS


SAMPLE


OF SAMPLE.


CHARACTERISTICS


CROSSTABULATION OF
POSITION TITLE


SAMPLE CHARACTERISTIC
BY SEX AND RACE .


CROSSTABULATION OF SAMPLE CHARACTERISTICS:
SPECIAL TRAINING OR EXPERIENCE IN WORKING
WITH OLDER PERSONS AND COUNSELING BY SEX
AND RACE . . .


CROSSTABULATION
POSITION BY


CROSSTABULATION O
NUMBER OF YE
SEX AND RACE


OF SAMPLE
EDUCATION


F SAMPL
ARS IN


CHARACTERISTICS
AND SEX. .


E CHARACTERISTICS:
PRESENT POSITION BY


nfl as, j,., fl rtr A ** a't' an e,&fn-ta-an r -nl


rnr r rr r nmn*rr nmr











Page


FREQUENCY OF RESPONSE CHOICES, MEAN AND
STANDARD DEVIATION OF SURVEY ITEMS


14-25


FREQUENCY RESPONSE CHOICES
STANDARD DEVIATION OF


MEAN
SURVEY


AND
ITEMS


36-46


ITEM MEANS (AND STANDARD DEVIATIONS)
SPECIFIED POSITION TITLES. .


ITEM MEANS (AND STANDARD
WORK LOCATION. .


FOR
. . .


DEVIATIONS)


SUMMARY OF F RATIO
VARIANCE FOR
ITEMS.. .


S FOR ONE-WAY
QUESTIONNAIRE


ANALYSIS OF
AND DEMOGRAPHIC


PEARSON CORRELATION COEFFICIENTS BETWEEN
ITEMS AND QUESTIONNAIRE ITEMS.


DEMOGRAPHIC


















stract


of Dissertation Presented


of the University


of Florida


to the Graduate


in Partial


Fulfillment


Council
of the


Requirements


COUNSELING


for the Degree


SERVICES


of Doctor


OLDER PERSONS


of Philosophy


AS PERCEIVED


PROVIDED


BY SELECTED


FLORIDA AGING PROGRAM ADMINISTRATORS


AND DIRECT


SERVICE


PERSONNEL


Milledge Murphey


June,


1979


Chairman:


Harold


Major Department :


C. Riker
Counselor


Education


This


staff

fined


study


towards

counsel


investigated


counseling se

ng, attitudes


the perceptions


rvices


of Florida


for older persons.


and perceptions


of subjects


Aging Program


subjects


toward


existing


services,


role


counseling,


self-evaluation


of training


in counseling


and gerontology,


and rating


of counseling against


other


services


were


assessed.


An instrument


to elicit


this


information


was


developed


field


tested


prior


to administration


to the whole


sample.


A 12


item


demnoranhi c


information


form and


a 61 item


u


questionnaire were


constructed.










A sample


of 414 subjects


was


identified


and chosen


at random.


Subgroups


consisting


program


administrators,


direct


service


providers,


and purchase


of service


project


staff were


included


from


each


of the


11 HRS Districts


and the State


Aging


and Adult


Services


Program


Office


in Tallahasse

administered


The researcher


the instrument


or his trained


statewide,


counterpart


and 373 usable


personally


questionnaires


were


obtained.


The resulting


data were analyzed


computer


using Pearson


Correlation


and One-Way


Analysis


of Variance


procedures.


Cross-tabulations


of 12


demographic


factors


and 60 questionnaire


item


responses


are


also


reported.


Item


61 of the instrument


and Items


10 and 12 of the demographic


form


required


open-ended


Each q

it discussed.


responses


questionnaire

Differences


and these


item was

among s


are reported


separately


ample


analyzed


separately.


responses


location,


subgroups, geographic


and other


factors


are


included.


In general,


the results


indicate


that


differences


in perceptions


of counseling


services


are most


notable


among

direct


State


Program Office


service


care


staff


and those


to older persons.


Lega


in positions

1 and other


which


provide


counseling


services


were


consistently


rated


below


those


of other


federally


funded


priority


services


such


as transportation


and home


services.


Subjects


tended


to evaluate


their


level


of knowledge


about


older


persons


as more


adequate


than


their


knowledge


about


counseling.


Overall


responses


tended


to support


the federally


established


definition


of counseling;


however,


differences


were


found


in the


extent


to which


subgroups


agreed


that


current


programs










counselors and


to provide


of the use


counseling


of paraprofessionals,


to the elderly


age-peers,


General agreement


or volunteers


was found


concerning


the adequacy


current


services.


Subject s


largely


agreed


that


counseling


services


should


be de-centralized


throughout


programs


rather


than


confined


specifically


to Aging


and Adult


Services


or Mental


Health


components.


Differences


were noted


between direct


service-workers


state


level


administrators


concerning


the adequacy


current


funding


levels


to provide


improved


counseling services


for older persons.


study


concludes


with a


discussion of


results


, suggested


explanations


of the data,


implications


of the study,


and suggestions


further


research,


counseling,


gerontological


training,


theory


practice.

















CHAPTER


INTRODUCTION


Background


Information


It is well


documented


that


the United


States


population


rapidly


growing older.


Over


22 million


persons


are age


or over


and they


comprise


approximately


10% of the total


population


(Health,


Education


Welfare,


1976


- 1977


1979;


Neugarten


1973


Rose,


1962).


year


over


000,


it is estimated


The state of


Florida


that


ranks


there


first


will


be 30,600,000 persons


in proportion


elderly


residents


(now more


than


20%),


and fourth


in actual


numbers


of older


persons


and it is experiencing


continued


rapid


migration


of additional


elderly


Giordano


into


state


Seaman,


1968


(Cutler


H.E.W.,


Haryoot an,


1977b;


1975;


Kincaid,


Florida,


1975).


1974;


Between


years


1890-1970,


Florida's


older population


experienced


a phenomenal


8,041.9%


increase.


In 1900


3,086


persons


over


60 resided


in Florida.


In the decade


between


1960


-1970


this


population


grew


from


774,000


1,348,000


(H.E.W.,


1977


United


States


Bureau


of Commerce


Bureau of


Census,


1972).


A considerable


amount


of data


now


available


about











opinions


has also


been


gathered,


although


a lesser


extent


(Butler,


1975,


Fact


Book


on Aging,


1978;


Harris,


1976).


Much


remains


to be learend


about


older


persons


from


both


biological


and psycho-social


perspectives.


In the field


of counseling


there


also


exists


a considerable


void


in both


research


and practice


in relation


to older


persons


(Blake,


1975


Boyd


Oakes


, 1973;


Jackson,


1977


Pressey,


1973;


Pressey


Pressey,


1972;


Schmidt,


1976).


Many


older


persons


do have


significant


problems.


They


experience


physical


decline,


tend


to be


more


conservative


than


younger persons,


more


greater


isolation


resistant


to change.


and loneliness,


They


can experience


be living


on reduced


a sense

and/or


fixed


incomes,


and may


lack


access


to adequate


social


services.


These


characteristics,


however,


are suggestive


only


some


older


persons.


In most


cases


the larger


in and


the problems


society


of itself


than


does


of the aged


of the older


not produce


are more


persons


poverty


correctly


themselves.


lack


problems


Aging


of transportation.


Such


problems


are situational


and reflect


the youth


oriented


commer-


cialism of


our society which


rather


systematically


undervalues


potentials


of aging.


Older


persons


are thus


frequently


denied


access


to resources


and means


to meet


their needs


(Bellak


Karasu,


1976


Boyd


Oakes,


1973;


Butler,


1975;


Fact


Book


on Aging,


1978,


H.E.W.,


1974).


The impact


an aging


society


on its educational,


economic,


and social

It nrTsaa r 4


institutions


significant.


Much


of this


information,


1on, AI a'vrnn r a o A n


in nr tmerir~l


rr 1 nrR~11


riaFn r; nt;~tn


n~tn nnr; nal











in coordination,


or duplicative


(Butler,


1975


Pfeiffer,


1976;


Vasey,


1975).

hensive


They

study


are frequently

of the issues


planned

related


without reference

to growing older.


any compre-


It is suggested


that


progress


in program development


for older


persons


may be impeded


by the negative

older persons t


views


hat


of aging


persist


and the


in the large


stereotyped

r population


attitudes


(Bellak


about


Karsu,


1976;


Florida,


1978c;


Harris,


1976


H.E.W.,


1975


Tuckman


Lorge,


1953).


That


these


attitudes


or "ageism,


use Butler's


term,


also


exist


among professionals


in the human


service


field


has also


been


deter-


mined


numerous


researchers


(Burdman,


1974;


gan,


1976


Frank-


father,


1977;


Garfinkel


, 1975;


Keith,


1977


Mutschler,


1971).


has also


been


noted


that


the devaluing


of older


persons


social


service


quality


personnel


type


can result


services


in their placing


provided


lesser


to the aged


importance


(Bellak


on the


Karasu,


1976;


Bennett,


1976;


Frankfather,


1977


Vasey,


1975).


Exploration


this


tendency


in terms


of perceptions


of counseling


services


for the aged


was the


purpose


of this


study.


Need


for the Study


This


study was


prompted


several


circumstances


relative


to the


role


of counseling


services


for older persons.


First


the counselor


role


a logical


one to be significantly


instrumental


in diminishing


ageism and


in facilitating


the delivery


other


social


services


-1


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( Ri i fr-


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tn nrrnr7ri


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direct


rnunselinf


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retirement,


are areas


in which


counseling


expertise


can


be of signifi-


cant


benefit


to the aged


(American Personnel


and Guidance


Association


1978;


Blake,


1975;


Bennett,


1976;


Boyd


& Oakes


, 1973;


Buckley,


1972;


Pressey


Pressey


1972)


However,


among


the variety


programs


servi

been


ces


currently


recognized


provided


and included.


Eor the aged,

Counseling


counseling

for older


has only

adults ha


recently


s largely


been


neglected


not developed as


a speciality within


the profession


itself


and a paucity


of research


exists


in both


theory


and field


practice


(Buckley,


1972


Pressey


Pressey


1972


Schmidt,


1976


Vontress,


1975)


Second,


recent


studies


have


attempted


to develop


means


assessing the


counseling


needs


of older persons


(Ganikos,


1977;


Myers


1978)


However,


little


data


have


been


generated


to date.


the interim,


appears


valid


assume


that


older persons


counseling


needs


are more


similar


than not


to those


persons


of other


ages,


and that


they


differ more


in degree


than


in kind


of need


(Boyd


Oakes,


1973


Butler,


1975


Kimmel,


1974


Pfeiffer,


1976)


Older


persons'


expressed needs


their


needs


as perceived


by others may


form


the basis


on which


counseling and


other


social


service


programs


are


developed and


justified.


It is these


perceptions


as currently


evidenced


in the field,


of the need


for counseling


servi


ces


that


this


study


has investigated.


Third,


there


is a need


for a clarification


and acceptance of


definitions of


counseling


in general


for counseling with


1n -f fri nfl l l r


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tn nmar' ~P


~nltncPlinb


nmtrrrm


Sn r









of other


services


as counseling


(such


as financial,


tax,


diet


counseling)


in aging program narratives,


Similarly,


a variety


personnel


in aging programs


are given


title


of "counselor,


although

include

Florida,


their

little

1978c


functions


both


counseling


Garfinkel,


1975;


description


(Florida,

H.E.W., 1


1978a


.976)


and actual


Florida


This


practice)


1978b


confusion


definitions


does


influence


the role


of counseling


servi


ces


in aging


programs.


Fourth, an

of accountability


d related


to the need


for the results


for definition,


of counseling


activity


is the problem


Lack


definition

counseling


leads


to difficulties


in programs.


in demonstrating


contrast


the effectiveness


can be clearly


demonstrated


that


certain


and that


this


classes


deficiency


older persons

has certain


not receive


predictable


adequate


effects


nutrition


on their


health.


need


It is relatively


(Meals-on-Wheels)


simple


to develop


and then measure


a program for meeting


the results


terms


this


of numbers


served and


health


benefits


to participants.


Counseling


servi


not readi

at best,


defined


to quantify


and many

. Yet,


of the benefits of counseling

such a mechanism is necessary


are difficult

if these


servi


ces


are to be provided


government


funded


programs


that


require


such accountability.


assessment


of perceptions


counseling


servi


for the aged


those


in the field


was


viewed


as needed


to form a


base-


line on which


to build


a more


accurate


and favorable


impression of


counseling


and its contributions.


ces


are


ces











programs


funded by


government


sources.


Included


among


the four major


areas


of need addressed


the Act


are


transportation,


housing


health,


and legal


other


counseling


servi


ces.


It is noted


that


the problem


of definition may


originate


in the wording


of the Older


Americans


which


ties


counseling with legal


services.


Each state


is charged


with


developing


a comprehensive


plan


describing


its methodology


for provision


of services


in these


four


areas.


However,


the Act


leaves


to the


state


the option


of deciding


for which


of the four


areas


it will


plan.


States


can,


legally,


concentrate


solely


on one


or two


areas,


although


this


not interpreted as


the intent


the Act


(Florida,


1977a;


Florida,


1977b;


19 7T


H.E.W.,


1977b)


a result,


counseling


servi


ces


have


received


little


attention


in terms


of both


funding


and program develop-


ment.


Although a


clear mandate


exists,


counseling


servi


ces


for older


persons


are not


receiving


adequate


coverage.


This


is also


true


other

1976;


allied


Boyd


health

Oakes,


programs


1973


such


Frankfath


as mental

er. 1977)


health

There


services

is a neei


(Bellak,


gener-


ate support


and acceptance


of the value


of counseling


for older persons


so that


such services


will


receive


an equitable


share


of funding


programming


along with


more


tangible


easily


defined,


and obvious


problems


such


as food,


housing


and transportation.


It is


suggested


that


the attitudes


of practitioners


and policy


makers


towards


counseling


services


for the aged


influence


the degree


to which


serving r


such


a IIeni as


services


-incl t ude


are provided.


nrnprams


Most


driei oned


federally


to meetP


funded


the needs


social


inL L


all eviat


H.E.W.,


.









form of


"means


test"


as a prerequisite for participation.


This


true


some


but by


no means


all aging programs.


The majority


programs


funded with


Older


Americans


Act monies


are without


a financial


eligibility


requirement.


Services


provided


under Title


Social


Security


Act do have


this


limitation.


Yet,


there


a tendency


to locate


servi


ces


for the elderly


in a


central


place


or agency


that


is often


tied


to the low income or welfare


population


This


practice


tend


to reinforce


the low


esteem with


which


social


service


pro-


viders


view programs


for the aged.


"extras,


such


as counseling,


be perceived as


unnecessary


frill


for programs


already


considered


welfare


based


and further


reinforce


the negative


attitudes


held


providers


towards


older persons,


aspect


of aging


programs


been


studied


with


relationship


to attitudes


towards


counseling


services


for older persons.


In summary,


it has been


stated


that


counseling


servi


older


persons


have


been mandated


law,


that monies


are available


fund


them,


that


the programmatic


planning


system


exists


to develop


these


servi


ces.


Fortunately,


some


assessments


of counseling needs


the aged are


being made.


That


counseling


for the aging


is not being


practiced may


be related


to the perceptions


of policy makers


and servi


providers


who believe


that


such servi


ces


are not


necessary,


are not


clearly


defined,


are difficult


to measure.


Programs


for future


generations


are being planned now,


and if counseling


is to be


integral


part


of them,


research must


demonstrate why,


and attitudes


ces


1 I r








Purpose


of the Study


It has been shown


that


the elderly


are currently,


and will


continue


to form,


a significant


segment


our population.


Many


these


older


persons


are or will


be potential


consumers


a variety


of social


services.


lack of


readily


identifiable


professional


counseling

attitudes


functions

of those i


in aging


n the fiel


programs

d towards


is perhaps


a reflection


such services,


This


of the


lack of


definition


of counseling may


reinforce


the tendency


for administrators,


social


service


providers


and agency


heads


to give


counseling a


priority


in relation


to other


services


aimed


at meeting more measurable


human


needs.


Should


counseling


be viewed


as a catalytic,


supportive


service


adj unctive


to other


services,


its funding


status


and practice


would


be enhanced.


Thus, the

attitudes towards


purpose


of this study was


counseling of


selected


to compare


employees


and contrast


in aging programs


funded


Florida


s Department


of Health and


Rehabilitative


Servi


ces.


This


study


has also


attempted


to determine whether


or not


a relation-


ship


exists


between


these


attitudes


the relative


importance


given


to counseling


program developers,


administrators,


and direct


service


personnel.


Additionally,


the study


has attempted


to determine with


what


relative


importance


subjects


viewed


counseling


as related


to other


services


provided


for older


persons.


Research Questions









did subjects


counselors


perceive


in aging programs


the role


of counseling


and how


they


and of


differ


their perceptions?


subjects


perceive


counseling


in relation


to other


services


provided


programs


for older persons,


they


differ


in their perceptions?


subjects


evaluate


current


status


of counseling


services


in aging


projects


programs,


and how did


they


differ


in their


evaluations?


did subjects


ability with


of the aged,


rate


respect


counseling


their


own


needs


services


level


of knowledge


of the aged,


techniques


characteristics


for the


elderly


client,


and how


did they


differ


in their


self-ratings


Rationale


Information


baseline


and conclusions


of information relative


drawn


to the


from t

current


his


study provide


status


of counseling


services


in Florida


s aging programs.


Although


the generalizability


these


results


be limited,


their


usefulness


for planning


com-


prison


purposes


should


be valuable.


Further implications


for other


research


and for program planning


can be expected


in several


areas


including


administration


, funding,


and other


areas.


The study


has implications


counseling


in terms


of research,


theory


practice,


and counselor


education


and the results


constitute






needed


attention.


Counselors


in training need


to be


aware


of the


current


services


actually


being provided


and attitudes


of administrators


staff


in aging programs


in the field may


obtain


towards cou

new insight


nseling.


into


Those


their


practitioners


positions


already


and the priori-


ties


given


to counseling


services


for the aged.


New roles


for counselors,


consultants


and trainers


, may


be recognized.


Finally,


the need


for further


research as


well


as maintaining professional


identity


integrity may


be implied.


Implications


for the field


of gerontology


also


include


possible


clearer


delineation


of the role of


counseling


in relation


other


social


services.


Clarification


of the role


of counseling


could


lead


to its re-evaluation


are established


for social


as national,


services


state,


and local


to the elderly


priorities


study


has also


made needed


contributions


to the body


of gerontological


research


that


it has


provided


a field


evaluation


of gerontological


counseling


terms


of the application


of research


theory.


Participation

to their increased a


the subjects


awareness


in the study


of the counseling


has probably


function


for older


persons,

attitudes

counseling


and has hopefully

which may be due


study


contributed

to ignorance


has perhaps


to the

both


encouraged


elimination


of aging process

participants to


negative

and of


become


more knowledgeable about


both


areas.


dat a


generated


this


study


will


be useful


to present


to state


and higher


level


policy makers


program planners


support


increased


counseling


servi


ces


and will


encourage


full


implementation


of the federal mandates.


Results


will


S--I


,,,.,1 3,


t


_


L )


-










Finally,


to improved


it is hoped


quality


that


of services


results


for older persons.


of the study will


Counseling


contribute


services


have


a needed


and beneficial


contribution


to make


to the welfare


of the


aged.


Perhaps


this


study


can serve


to enhance


quality


of older


persons


' lives


through


improved


counseling services


and improved


attitudes


towards


these


people.


Definition


of Terms


The following


list


refers


to terms,


acronyms,


and agencies,


to which


frequent


reference


been made


throughout


the study


- Counseling:


process


whereby


assistance


is given


to help


resolve


social


and/or


emotional


problems


through


the establish-


ment


a therapeutic


relationship


and application of


skilled


interviewing


, listening


and problem solving


techniques


(Florida,


1978b).


- Older


Person:


A person


or over


limit


definition,


as "older,


" "aged,


or "elderly"


varies


between


and 65 and above.


Sixty


appears


the most


commonly


agreed


upon


classification


(H.E.W


,1977a


Neugarten,


1973)


- Aging


Program:


Those


programs


funded


a combination


federal


, state,


and local monies


that


are channeled


through


the Florida Department


of Health


and Rehabilitative


Servi


and administered


the Offi


of Aging


and Adult


Servi


(including Areawide


Agencies


on Aging).


ces


ces










- Older


Americans


Act:


initial


legislation


that


mandated and


provided


funds


for major programs


and services


for older perosns


nationwide.


- Employee:


Administrative


staff


in the


state


program office,


administrative


staff


in the district


program offices,


Areawide


Agency


on Aging


staff,


aging


projects


staff


, specialized


adult


services


staff,


and community


care


proj ect


staff.


- Specialized Adult


Services


(SAS)


direct


social


services


component


of Aging


and Adult


Services


offices


that


provides


face-


to-face


client


contact,


resulting


in the provision


trans-


portation,


medical,


housekeeping,


chore,


escort,


guardianship,


and other


services


for older persons.


Organization


of the Remainder


of the Study


The remainder


of the study


is presented


in four


additional


chapters.


Chapter


II provides


a review


of the


current


literature


on topics


germane


to the study.


Chapter


III describes


the methodology used


to conduct


research.


Chapter


presents


the results


of the study


including


data


analysis.


Chapte

implications


V includes


of the study.


a summary,


discussion


su2eestions


of the results,


for further research.
















CHAPTER


REVIEW


OF THE


LITERATURE


Characteristic


and Needs


of Older


Persons


An understanding


of the


basi


needs,


characteristic


and changes


that


can accompany


growing older


necessary


for counselors


other


social


services


providers.


Misconceptions


about


aging


and the


abilities


of older persons


can lead


to development


of negative


per-


ceptions.


type


As noted


and quality


previously


of servi


ces


such


provided


negative


to older


views


can influence


persons.


Additionally,


there


some


evidence


that


exposure


to gerontological


information


through


training


and/or


cont act


with


older persons


does


tend


to improve


unfavorable


understand


attitudes


the origins


(Ernst


Shore,


of commonly


1975)


held


In order to


stereotyped


views


adequately


of aging


older persons,


a review


of major


areas


of need


and characteristic


the elderly


necessary


Attention


is also


directed


towards


identifying


those


areas


of needs


and problems


which


can be effectively


addressed


counselors.


Demographi


data and


broad


categorizations


of the older population


have


been generated


several


comprehensive national


and state


surveys.


recent


years


the Harris


Poll,


Bureau


of the


Census


data,


the Florida










individual


older persons.


Some


categorization is necessary,


however,


needs


are to be identified


and effective


programs


developed


to meet


them.


Several


facilitated


social


the rapid


economic


increase


forces


in this


have


country


led to conditions


s population


which


of older


persons.


With


few exceptions,


the fertility


rat e


has continually


declined


until


the United


States


now


approaches


a "zero"


population


growth


level.


Simultaneously,


improvements


in nutrition,


medical


knowledge


and servi


ces


and control


of infant


mortality


have


increased


Americans


average


age by more


than


six years


1900.


Further,


predicted


that


our population will


experience


a change


from


average


(H.E.W.


of 23


1978)


years


in 1900,


It is thus


to an average


apparent


that


age of 38 years


the problems


in 2035


and issues


face


today


in dealing with


the needs


of older persons


will


continue


be of increasing importance


in both


very near


future


and the coming


decades.


Prior


to a discussion


of specific needs


of this


group,


it is


important


to note


that,


in general


, socio-economic


conditions


for most


older persons


can be expected


to improve


as the population


as a whole


ages.


However,


problems


will


still


exist.


one source


states,


. .the


segments


of the older population


that will


be growing most


rapidly


[the


oldest


of the old,


women,


persons


races


other than


white]


will


be the


same


groups


that


have


suffered more


from such


common


problems


the elderly


as poor


health,


social


isolation,


poverty"


(H.E.W


1978,











in income


generally


follows


retirement


and older


families


frequently


begin


to depend


upon


outside


sources


of financial


assistance.


Although


by no means


are all older persons


living


poverty,


many must


exist


on lowered and/or

of older widows s


fixed


ubsist


incomes.

on incomes


For example,


below


an estimated


established


one-fourth


governmental


poverty


levels


alterations


(H.E.W.,


in other


1976)


areas


Economic


including


fluctuations


changes


also necessitate


in lifestyle,


residential


relocation,


and loss


of financial


security


for emergencies


(H.E


1978a)


Reduced


incomes


frequently


require


older persons


to turn


social


service


agencies


to meet


their needs


for housing,


food,


trans-


portation,


and medical


care.


For a generation


unaccustomed


to receiving


financial


aid,


both


the fact


of being


needy


and the


process


of becoming


a recipient


such services


can be emotionally


devastating g


(Bellak,


1976;


Bennett


, 1976;


Butler,


1975


; Hollender,


1952


Frankfather,


1977)


This


problem is


further


compounded


the negative


attitudes


held


social


service


providers


towards


their


elderly


clients.


Although


only


a minority


older persons


are wholly


dependent


on agency


support,


many


staff


workers


tend


to view


all in this


see the aged


less


capable


than


they


are (Burdman,


1974;


Bellak,


1976;


Bennett,


1976


Frankfather,


1977)


Counselors


and counseling


techniques


could


facili-


tate and


humanize


agency


procedures


as well


as educate


social


workers


the needs


and sensitivities


older


persons with


restricted


incomes


PrPQCCPvn A


1 Q71t


fundtt pu


1Q79


1Q7S


Prp $sv -


IRnv~l


fi, n~tpC


Rtit 1 Pt


. .


-


-


.










changes


accompanying


retirement


can be detrimental


to the welfare


older persons


(Andersen,


1969;


Maddox,


1970


Jackson,


1977).


This


is particularly


true


for the


current


generation


of elderly who


were


reared


in an era which


placed


a high


value


on work,


productivity,


and economic


independence.


youth


and leisure


orientation


today


s society


further


devalues


the older


retirees'


position.


only


do they


not work,


they


frequently


lack


the ability,


interests


means


to play


successfully


(Kleemeier,


1962;


Carp,


1972).


Retirement,


particularly


for men,


also


means


a tremendous


shift


downward


status


and in feelings


of self-worth.


effects


of these


changes


have


been


fairly well


researched,


as have


the corresponding


changes


affecting


older women


left


with


the "empty nest"'


syndrome


(Berardo,


1972;


Bloom


& Munro,


1972;


Bock,


1972


McKain,


1969;


Shanas,


1969).


need


adequate


pre-retirement


planning


has been stressed


and such


planning


would


assist


in preventing many


of these


related


problems which


accompany


this


change.


counselor'


role


in meeting


this


need


been


described


and emphasized


several


authors


(Andersen,


1969;


Baker,


1952;


Buckley,


1972;


Carp,


1972;


Monk,


1971,


Schmidt,


1976)


Although retirement may


still


be mandatory


some


older per-


sons


today,


many wish


to continue working


either


from


economic


necessity


or personal


desire.


difficulties


faced


by middle-aged


workers


seeking


career


changes


loom even larger


for persons


past


Enforced


retirement


indicates


an attitude


that


older workers


are less


necessary,


less


capable,


and should make


room for younger


employees,


one











older


employees.


the origin


many


A review of


commonly


these


held


capacities


stereotyped


is helpful


and negative


in clarifying


attitudes


about


mature


workers.


Palmore


notes


that


itself


should not


the sole


criterion


for retirement.


Increased


life


span


and improved


health


should


encourage


employers


to retain


older workers.


Flexible


rather


than mandatory


retirement


systems


would


benefir


economy


and allow


employers


to retain


the skills


and expertise


of older


workers.


Poor


attendance,


illness,


and lowered


safety


performance


not inevitably


correlated


with


increasing


age among workers.


Finally,


it is noted


that


providing


late-life


career


options


improves


older


persons


' self-sati


faction


and esteem while


reducing


somewhat


economic


hardships


imposed


retirement


(Palmore,


1976;


Rehm,


1971).


summary,


can be


seen


that


these


aspects


of retirement


have


significantly


contributed


to devaluation


older


people,


particularly


in economic


terms.


The older person seeking


a new


career


or retraining


a post-


retirement


also


encounter


resistance


and problems.


Social


ser-


vice


and rehabilitation


priority


despite


agencies


considerable


tend


research


to give older

evidence that


applicants


their


potential


success


placement


is realistically


high


(Donahue,


Berry,


1953;


Ernst


Shore,


1975;


Rasch,


Crystal,


Thomas,


1977


Rehm,


1971;


Sheppard,


1971).


s conceptions


about


older workers


' abilities


limited

f r t t-


program


funding,

n1 -i pn t Q T*


n thncp


r th


an attitude


n 1 nnop'


7


that


services

nrndir t ir


should

Tu Pnrc


given


are


tP rm I-i


nhParl


I










programs


are frequently


oriented more


towards


recreation


than


vocational


development.


The employment


and educational needs


of older


persons


are predicted


to continue


increasing


and social


service


agencies will


also


become more


involved


in these


concerns


(Donahue,


1953;


O'Dell,


1957


Vontress


, 1970).


Thus,


it is important


that


employees


of these


agencies


become


better


informed


about


the needs


and capabilities


of the elderly


terms


of work


and school.


Coun-


selors


access


can play


to the


a very vital


employment


role


in facilitating


and educational


services,


older persons'


in dispelling


the negative


images


and attitudes


of social service


and rehabilitation


workers


towards


older persons'


intellectual


and vocational


potentials


(Buckley,


1972;


Grawbowski,


1972;


Griswold,


1971; Vontress, 1970).


Health Needs


and Characteristics


Despite


commonly


held misconceptions


not a disease


state


and does


not produce


one identifiable


debilitating


condition.


health


problems


of older


persons


are chronic,


complex,


and frequently


are not


significantly


improved with


treatment.


Although


geriatric


research


has produced


some


remarkable


insights,


causes


of most


degenerative


changes


associated with


remain


unknown


(Busse


Pfeiffer


, 1976;


Fact


1978


1974)


This


situation


further


compounds


attempts


consisting of


at medical


treatment


care


symptoms


frequently


only


results


and maintenance


a regimen


of the


status


quo (H.E.W.,


1974).


H. E. W.









and personality


changes


and the psychological


effects


attributed


aging


are in large measure


reactions


to health


states


rather


than


chronologically


determined


processes


alone"


(H.E.W.,,


1974


this


area,


common


belief


that


older persons


are very


concerned


with


their


health


more


realistic


than


not.


In truth,


the incidence


of ongoing,


and these


debilitating,


illnesses


disablin


do restrict


conditions


older persons


does


increase with


mobility,


sensory


acuity


and general


feelings


of well-being


(H.E.W.


1978)


, These


changes


in health


and physical


functioning which


characterize


older persons


can result


in development


Health


concerns


several


areas


of older persons


of problems


living


on reduced


and needs.


incomes


lead


to their


dependence


on public


agencies


and subsidized medi


care.


some


cases,


older


persons


go without


needed medi


attention


because


of lack of money,


ignorance


of available


services,


or reluctance


to become


dependent


on agency


assistance


(Bellak


1976)


These


health


problems


are compounded


practitioners


towards


by the


elderly


attitudes


clients


of social


and patients.


workers


Thus


despite


increased


need


for medical


services


among the


aged,


medical


providers


are sometimes


reluctant


ive them


adequate


or appropriate


attention


(Bellak,


1976


H.E.W


., 1974;


H.E.W.,


1978).


origins


of negative


attitudes


among


allied medical


pro-


fessionals


towards


the health needs


of older


persons


are


complex


and are


discussed


more


fully


in succeeding


sections.


At this


point,


it is


relevant


to note


that


dispelling


these misconceptions


difficult,


can











mature


families


who must


deal


with


an older parent


s or spouse


declining


health and


the dilemma


of increased


life


span


coupled


with


physical


limitation.


Living Arrangements


living


significant

persons sug


patterns


change and need.


guestss that most


of older


Although


of them


persons


constitute


a prevailing


are frail,


an area


image


incapacitated


of older

residents


centers


(approximately

so confined, i


and nursing


are in such


t is estimated


homes, in reality


institutions


that


only


(H.E


a considerable


a small


., 1978)


number


percentage


Of those


could


capable


of independent


or semi


-independent


living if


adequate


supportive


servi


ces


were


readily


available.


A detailed


discussion


of the


cost


inadequacies


of institutional


care


for the elderly


beyond


scope


of this


review.


Yet,


counselors


need


to be


aware


these


factors


can make


a valuable


of nursing home


contribution


residents


(Manney,


towards


1975;


meeting


Montgomery


the specialized


1972


needs


Pressey


Pressey,


1972).


Alternative


living arrangements


for older persons


are available


which


reflect


their


housing needs


Housing


complexes


government


subsidized


residences


make


affordable


housing


access


ible


to older


persons


on limited


incomes.


Such


complexes


can also meet


the personal


security needs


of older


persons


as well


as be


access


to the


-ar -


04 '-.~ 1 1 n 4 2 -t i- -ra. -- -C ,- -A 2 -A.


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z


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i"


I










which

group


counselors


can direct


and consultant


their


services


efforts


(Boyd


toward


& Oakes,


providing


1973


Stevens


individual,


1972


Non-government


housing


for older persons


frequently


takes


form of


age-segregat
aCT~k-Ca~rVQ~af


subdivisions,


apartments


and restricted


"adult"


communities.


These


developments


do meet


the needs


and the residential


preferences


of a large number


of older persons


for whom


such


arrange-


ments


are economically


feasible.


As with subsidized housing


residents


of these


projects could also


benefit


from


counseling


servi


ces


(Fact,


1978;


Stevens,


1972).


A noticeable


trend


among


older persons


is that


an increasing


number


of them are living


alone.


source


notes


that


in the


past


years,


the number


of lone


older


persons


grown


three


times


faster


than


would


be estimated


from overall


population


growth.


Further,


proportion


of non-ins


titutionalized


elderly


living alone


increased


from one-sixth


(1960)


to one-fourth


(1976)


(H.E


1978)


The largest


increases


single-person


households


are among women


the "old


old"


subgroups


(H.E.W.,


1978)


Should


this


trend


continue,


then


the demands


for social


service


programs


to meet


the special


needs


of lone older persons


can also


be expected


to increase.


The need


home


services


is particularly


evident


in light


of the intent


and focus


of aging


legislation


that mandates


maintenance


independent


living


in the community


for the elderly


(Florida


, 1978a)


. In


terms


per-


ceptions


and attitudes


the notions that most


older persons


require


great


amounts of


care,


need


to be institutionalized


or are incapable


of self-


r











Attention


should


also


be drawn


to the living


arrangements


widows,


particularly


because


these


older women


constitute


a substantial


number


of those who


reside


alone.


Several


factors


give


rise


to the


special


families


needs


through


problems


geographic


of older women


mobility


and widows.


has contributed


Separation


to the decline


multi-generational


families


living


together


and thus


to widows


' isola-


tion


(Field,


1972;


H.E.W.,


1978;


Kent


1972).


The majority


remarry


and so continue


to live


alone


on limited


incomes


(H.E.W.,


1978).


Social


services


have


only


recently


focused


on the needs


of this


group


and projects


such


as the Displaced


Homemaker programs


have


helped


to solve


some


of the problems


of these


persons


(Florida,


1978b).


Counselor


contributions


to the situations


faced


by widows


and widowers


have


been


noted


several


authors


(Buckley


1972


Jackson,


1977


Kalish,


1971,


Moberg,


1972).


Social,


Activity


Family


Needs


The changes


in lifestyle


which


can accompany


retirement


have


been


noted


previously.


There


are additional


implications


in terms


the social


and activity


needs


of older


persons


and the changes


that


characterize


more defined,

system. The


viable

current


the mature


roles

trend


family.


for older

towards m


Previous


generations


persons within


maintenance


included


an extended


an isolated,


family

nuclear


family


has largely


negated


these


roles


(Berardo,


1972


Jackson,


1977


q l-A 1Q7 1 1 ntor-cn ?rnn nn


i mnmnrninsd


r 9 cl 9 ~


Sh nn a c


1973


UnwPtrP r


rnn t a r t










many


older


people


reside


alone


. .almost


no one is without


some


kind


contact


with


other


members


of his


family"


(Thompson


Streib,


1961,


. Indeed,


some


sources


predict


a resurgence


of multi


generational


families,


and renewed


importance


the grandparent


role.


These


changes


are partially


attributed


to the longer


life


span


the economic dependence


of more


older persons


on their


adult


children


(Hader,


1965


1978;


Tartler


, 1963


Streib,


1965)


Another


event


characterizing


adult


family


changes


is the


marriage


of older parents.


family problems


and may meet


Such

with


a decision c

significant


an lead


to considerable


resistance


from


adult


children.


Whether


the late marriage


between


two older persons


or one younger


or one older,


opposition


to these matches


is indicative


of several


commonly


held


prejudices


stereotypes


about


older persons.


It i


believed


some


that


older


persons


continual


interest


in and


need


for marital


closeness


and sexual


relationships


are unnatural


worst


and not


normal


at best


treib,


1965;


Sussman,


1972;


Sweetser,


1963)


This


an area


in which


marital


and family


counseling


services


can be of

children


significant


as they


benefit


cope with


to both


the realities


der parents

of older p


and their


persons


adult


needs


(Bock,


1972


McKain,


1969).


problems


and needs


older


persons


encounter when


facing


death


and dying have


received


considerable


attention


in the literature of


recent

that


years.


affect


most


loss


areas


a spouse

an older


or older


person


parent


s life.


requires

The grief


adjustments

process


re-


H.E.W.,










Wass


(1979)


indicated


that


while


one man


six,


or over


widowed,


women


have much more


prominent


marital


bereavement


problems.


years


age,


50% of


women


have


lost


their husbands


and by


years


two-thirds


have


experienced


loss


spouse.


These


data


support


the contention that older persons


are survivors


In addition


to the 1


oss


spouse


older persons


must


also


cope with


the 1


oss


of relatives,


friends


and acquaintances


many


of whom may


younger.


Older persons


experience


bereavement


overload,


that


the phenomenon


not having


enough


time


to deal


with


the grieving of


one 1


oss


before others


occur.


As stated,


only


recently


have


we learned


that


grieving


takes


much


longer


than


believed and


and physical


that


among


illness


the gri


even


reactions we


death.


Grief,


find


then,


are psychological


a constant


companion


in old age


" (Wass,


1979


200)


Connected with bereavement


changes


is the tendency


for many


older persons


to experience what


has been


termed


the life


review


(Butler,


1975)


Further,


life


review therapy


been


recommended as


an effective means


for counseling


older persons.


kind


of therapy


does


not require


a psychotherapist,


nor


an office


or medical


setting


necessary


can be carried


out in the home,


at recreation


centers,


in the home of


the older person,


or in


a nursing


home.


The counselor


must


possess


basi


skills


in active


listening,


must


have


a great


deal


empathy,


and should have


a basi


knowledge


process


aging.


However


. 2rief


counseling


can be provided by


persons


with


relatively


was










life


review


and related


reminiscing


activities


contribute


to the stereotyped


views


that


older persons


are entering


a second


child-


hood,


that


they


are incapable


of coping with


present,


and, therefore,


that


they prefer


to retreat


into


past


memories.


Again,


informed


coun-


selors


can both


facilitate


psychological


process


and help


dispel


erroneous


interpretations


of it.


Increased amounts


of leisure


time


availabi


to older persons who


are no


longer


employed


constitute


a marked


change


from


their


earlier


years.


Recreation


leisure


activities


and volunteerism have


been


commonly


sought


avenues


of meaningfully


using


this


time


(Harper


Garza


, 1969


Messer,


1968


Stickle,


1977)


increased


free


time


for retired


lessness,


older persons


inactivity


can produce


isolation.


boredom,


The elderly


feelings


have


use-


a particular


need


at these


times


for continued


involvement


stimulation.


Stereo-


typed


perceptions


of older persons


as incapable


of learning


further


restrict


their


access


to needed


programs


and activities


(Butler,


1975


Carp


1972


Fact,


1978


Frankfather


, 1977


Kilty


Feld,


1976)


Social


service ag

the social

realize th


encies


and workers may


and recreational


e potential


needs


spin-off


tend


to place


of their


benefits


older


active


little


importance


clients,


involvement


and not

can bring


to older persons.


These


benefits


can al


be realized


for the elderly


reside


of need


in nursing


which


homes


can effectively


and institutions.


be addressed


Again,


this


counselors


an area


(Miller


Lowen-


ata ~ 1Jn TAI t nn


1Q76*


S n1ischiir


19 74r


S t pue s~


1973*


Vnntress.


1975)


~5ain










Percept ions


and Attitudes


Towards


Aging


preceding discussion


of characteristics


of older persons


has emphasis

percept ions


the origins


and negative


from which


attitudes


several


towards


commonly


the elderly


held erroneous

derive. The


existence


of such


stereotyped


views


of the elderly


can influence


quality


notes


of social

. how


servi

aging


programs


and the aged


provided fo

are viewed


r them.


a vital


one author


factor


determining the


policy


set for


aging services


by program developers"


(Vasey


, 1975


. Although


virtually no


research


has been


done


attitudes


towards


counseling


servi


ces


for older persons,


there


been


substantial


investigation


into


attitudes


towards


aging.


Some


of this


work has


focused


on the perceptions


of program administrators


direct


service


providers,


and trainees


in the allied


helping


professions.


This


section


factors


will


that


review


have


these


been


studies,


identified


types


as influencing


of instruments


attitudes


used,


towards


older persons


and the effects


of such


perceptions


on service


delivery


Attitudes


have


been


defined


. .ideas,


opinions,


beliefs,


sets,


prejudi


ces


values


, etc.,


that


are acquired


through


learning


that


predispose


one


to react


a certain manner


to other


ideas,


persons,

towards


objects


aging and


etc." (Hopke,

older persons


1968,


are not


That


uncommon


negative


attitudes


is evidenced


coining of


terms


such


as "ageism"


and "gerontophobia"


to d


describe


these


disparaging perceptions.


Counselors


need


to be concerned


about


such


n tt1 t wit-Inc


anA r o fl onI- rno7 nI .-~ TO nf "a t nl a knl -.-n:~


A-1---


I-


S*n w_


~nrl tha


rnotr n


t,,,


i mn ant


t ,,,


,c, cl


fk /


n r~u










Areas


of Research


on Attitudes


Towards


Aging


the Aged;


Instruments


Investigators


into


attitudes


towards


older persons


towards


aging


have


concentrated


their


studies


on several


main


categories


subjects.


A considerable number


of studies


have


been


done


using students


of varying ages


and college


trainees


enrolled


in health


oriented


curricula.


Similarly,


pioneer researchers


in these


areas


developed


the most


frequently used


instruments


using


student


age subjects


(Ivester


& King,


1977)


Such


studies


as these


tend


to concentrate


on correlations


of attitudes


towards


the aged


characteristic


of the respondents


terms


of the subjects


' own


age,


educational


level,


amount


contact


with


older persons


This


approach


to attitude


research


has been


considered


deficient


in its omission


of other


cor-


relating factors


such


as characteristic


of different


groups


of older


persons


(those who


live


independently


versus


the institutionalized,


example)


(Keith,


1977).


Another


category


of research


into


attitudes


towards


aging


identifies


three


major


areas


investigation


(Mutschler,


1971)


First


are the measures


of attitudes


towards


aging


the aging process


perceived


subject s


of various


ages.


This


approach


also


includes


those


studies


dealing with


attitudes


of older persons


themselves


toward


growing older


early works


of Tuckman,


Lorge,


and Kogan


are representative


of this


aspect


Second,


measures


psychological


characterist i


of individual


are studied which mav


be relevant


*u


LJ


I











adjustments


made


older persons


to growing


older.


Studies


using


instruments


such


as the Life


Satisfaction


Ratin g


Scale


fall


into


this


area.


Research


in these


areas


generally


relied


on relatively


questionnaire


to different


oped


and survey


subj ect


questionnaires


instruments


groups


utilizing


that


purposes


semantic


have


Early


been modified


investigators


Likert


differential


or adapted


devel-


and other


types


of rating scales


and most


recent


studies


have


relied


on these


or modifications


of these


instruments


(Burdman,


1974 ;


Colgan,


1976;


Eisdorfer


& Altrocchi,


1961;


Garfinkel,


1975;


Ivester


& King,


1977;


Keith


1977


; Mutschler,


1971;


Rasch,


Crystal


Thomas,


1977


Ross


& Freitag


, 1976;


Walter


, 1976)


early works


of Tuckman


Lorge


resulted


in the


development


of the frequently used Attitudes


Towards


Old People


Scale.


Based


studies


using graduate


students


in the early


1950


this


questionnaire


probes


areas


relating


to physical,


sensory,


financial,


conservatism


and other


factors


influencing misconceptions


and stereotypes


about


aging


and older


persons


(Tuckman


Lorge,


1953)


These


two researchers


have


also


developed


an Older


Workers


Questionnaire


however,


it is not


as widely used


(Mutschler,


1971)


Kogan


has developed


another


frequently


used


instrument


similarly


titled


Attitudes


Towards


Old People


Scal


This


a 34 item Likert


type


scale studying areas


commonly


held


stereotypes


towards


aging


(Ivester


& King,


1977;


Kogan


1 flCI\\


yr,~1 ,


C IT an


I "n I~ o It I us. l glu


(1QSQ1


hnuVP


a1 Qn


nrvlPl nnonA


a _qnt pnrs


romnl ~ietlo


II


I








including dependency,


instrumentality,


and accredibiltiy


(Ras ch,


Crystal


Thomas,


1977


Ross


Freitag,


1976


Walter,


1976)


In addition


to these most


frequently used


instruments,


several


others


have


been


developed


to study


different


aspect s


of attitudes


and adjustments


towards


aging.


Oberleder


s Attitudes


Toward


Aging


Scale


(1961)


has received


some


use


(Garfinkel,


1975).


Sroles


developed


an instrument


in 1956


assess


factors


related


to choice


work


with


the aged


(Mutschler,


1971).


Several


instruments


have


been


created


study


satisfaction,


adjustment,


and emotional


well-being


older


persons.


Notable


among


these


are the Maddox Morale


Scale


(1963),


Neugarten


& Associates


Life


Satisfaction


Rat ing


Scale


(1963)


Lowenthal


s Measurement


of Interaction


(1965),


and Kastenbaum


Hospital


Questionnaire


(1967)


(Mutschler


, 1971)


Of the few studies


devoted


to research


on attitudes


program


administrators


and others who


determine


policy towards


servi


older


persons,


several


of the above


mentioned


instruments


have


been


utilized.


studies


Oberleder


involving


s Attitudes


psychiatrists


Towards Aging


clinic


Scale


directors


been


used


(Garfinkel,


1975)


However,


several


the most


informative


studies


using


this


category


subj


ects


have


relied


on instruments


developed


the researchers


modifications


of existing


scal


es.


Keith'


study


stereotypes


about


older persons


among


administrators


used


an eight


item,


five


point


Likert


scale


developed


the author


(Keith,


1977)


A particularly


compre-


hensive


study


administrators,


planners


and legislators


used


Qsri PQf


,i f nfnrf' rmnrinn


cPQopk-l no


niiec I nnen


rntliar


tfh 9n


I If-S


tTT^oa nt


ces











using


a questionnaire


format


which


he developed.


The works


of these


authors

attitude


mine


suggest t

s towards


perceptions


hat


the traditional


aging


and older


subjects


such


instruments


persons


used


assess


may be inadequate


as administrators


to deter-


and direct


service


providers

available


sufficient,


towards


measure

it would


services


for the elderly.


perceptions

seem necessa


and attitude


Although

s towards


and justified


the tools

aging appear


to create


a new


instrument


to investigate


social


service


personnel


attitudes


towards


counseling


services


for older persons.


The rating


scale


and question-


naire type formats


appears


most


frequently


used


and appropriate


for this


area


of inquiry.


Attitudes


Towards


Practitioners


Aging Among Trainees,
and Administrators


A closer


examination


of several


studies


into


the attitudes


student


trainees,


social


service


and health


practitioners,


and policy


makers


and administrators


is helpful


for several


reasons.


Although


these


studies


not focus


specifically


on counseling


services


older


persons,


there


are some


commonalities


and a number


of the authors


noted


the need


for the contributions


counselors


can make.


Second,


subjects


of these


studies


will


enter


or are currently


engaged


in health


and social


service


programs


older


persons


and their


attitudes


towards


their


clients


and their work


are crucial


to the successful


provision


of services.


Many


such


personnel


are the


ones


with


whom


new










A number


of studies


have


looked


at the attitudes


various


groups


those


ages


dealing with


of students.


perceptions


This


review will


of college


concentrate mainly


and graduate


students


because


these


findings


seem


to be more


pertinent


than


those


involving


much


younger


younger


persons


subjects.


' attitudes


Bennett


towards


has reviewed


a number


the elderly.


of studies


notes


that,


overall


the results


have


indicated


that


training


and/or


contact


with


older persons

although such

She concludes


tends


to reduce


improvements


advising


or develop


are not


that


always

terms


ess


negative


significant


of attitudes


attitudes,

or lasting.


A concerted


effort


should


be made


to stop


perpetrating


the view


the aged


'them'


young


as us'


Everyone


ages


aged


are not


exotic minority


group


towards


whom


some


people


can feel


detached


sympathetic"


(Bennett,


1976,


137).


Burdman


s study


of student


and trainee


attitudes


noted


. .void


in terms


of reciprocal


professional


understanding"


between


students


in gerontology


and rehabilitation


counseling


(Burdman,


1974,


. 66).


This


lack of


mutual


erstanding


further


compounds


problems


generated


the subj


ects


' negative


views


of older


persons


(Burdman,


1974)


Colgan


noted


that


attitudes


toward


older


persons


improved


slightly with


participation


students


in a gerontology


course (Colgan,


1976).


Ivester


& King


also


reviewed


research


involving


older


adolescents


perceptions


of old


er persons.


They noted


-. tenepnnrv


for all


Rap Qrf1nn


tn view


the a ed


as nossessinae


stereo-


h











Differential,


they


assessed


rehabilitation


counseling


students


attitudes


towards


both able


and disabled


older


persons.


Results


dictated


a tendency


to view


older


persons


as less


feasible


habilitation


servi


ces


than


younger


handicapped


clients.


These


findings


are particularly noteworthy


in view of


other


research


which


the authors


state


workers


. .clearly

to profit f


demonstrated


rom vocational


the abilities o

rehabilitation


f older


services


sailed


" (Rasch,


al.,


1977


126)


The authors


conclusions


from


study


particularly


relevant


in view


the existence


of rehabilitation


counsel-


and similar


service


programs


within


the Florida


system.


As they


state


. .this


apparent contradiction between


counselor


opinions


objective


research


suggests


the possibility


of biased


attitudes


towards


the old


among


rehabilitation


personnel


And,


further,


they


note,


"Although


gated

this


the aging


issues

research


stereotype


in gerontology,


concerned


one of the most


it is only recently


the attitudes


extensively

that a major


of human service


investi-


focus


professionals"


(Rasch


et al., 1977,


124).


Ross


Freitag


have


compared


adolescent


and adult


attitudes


toward


the aged and


also


noted


that


such


perceptions


improve


with


and with


contact


with


older


persons


(Ross


Freitag,


1976)


Seltzer


& Atchley


reviewed


literature


young persons


to evaluate


presence


therein


stereotyped


views


of aging


and older


persons.


They


noted


a consistent


tendency


towards


negative


portrayals


of older


ners os


(Rel tzer


& Atrhlpv.


1Q71\


Ac nntf-oA


nr-cnrl ?l 1,7 \r n


re-


are


/V-


Tll~tm~n










attitudes


of undergraduates


in social


work and


in non-related


fields


towards


work students


elderly


held more


His results


positive


indicated


attitudes


that


than


graduating


did either


social


beginning


social


work


students


or students


in other fields


(Walter,


1976)


Research


into


attitudes


of social


service


providers


practitioners


has dealt mainly with social


workers


mental


health


personnel


nurses


and physicians.


Studies


of this


type


have


been made


more


difficult


because


the dynamic


the influence


the subjects'


fears


and attitudes


about


aging


as well


as their


opinions


about


older persons.


invest i


at ions


into


physicians


' attitudes


perhaps


best


illustrates


situation


for their professional


competencies


(the need


to "cure"


and to


preserve


life)


have


been noted


as contributors


to their


negative


views


of aging.


one author notes,


the goal


medicine


seen


as victory


over


death,


then


those


patients


because


are closest


to death


are bound


to be viewed


negatively"


(Bellak,


1976


17).


This


author


further


points


the threats


to a physician

relationship


s sense


he has with


of control,


older


authority,


patient s


competence


and the effects


these


in the

conditions


have


on doctors


' perceptions


of the elderly


Physi


cians may mis-


interpret


the older patients


own attitudes


and motivations


as self-


pity


dependency,


or stubbornness


all of which


further


intrude


upon


an open,


communicative


relationship


(Bellak,


1976).


Negative


reinforced


views


, perhaps


of older


unavoidably


persons among

, because they


medical

rarely


personnel


are


see the majority


own











the aged,


that


nothing


can be done


about


it, and


that


the little


that


can be done


is hardly worth


doing"


(Palmore,


1976


37).


potential


a circular


type


of self-fulfilling


prophecy to


develop


from


these


attitudes


apparent,


and similar


circumstances


have


been


noted with


other


health


and social


service


providers


working with


the aged.


Other


sources


have


also noted


the tendency


among


physicians


to disregard


symptoms


presented


older


patients


as being


either untreatable or simply


due to the


uncertainties


aging


(Bellak,


1976;


Boyd


& Oakes


, 1973;


Pfeiffer,


1976).


attitudes


of mental


health


workers


towards


the elderly


have


also


been


extensively


investigated.


As Pfeiffer notes,


. .there


evidence


that


prejudices


against


the elderly


are not


confined


to lay


society,


1976,


attitudes


but als

192).


are also


are present


As with


among


the physician


affected


their


the health

ns studied,


personal


professions"


mental


fears


(Pfeiffer,


health workers


aging,


older


persons


frequently


embody


these


fears.


Butler


also


noted


the influence


ference


of what


for mental


is termed


health


the YAVIS


personnel


syndrome,


to work with


that


patients


pre-


are young,


attractive,


verbal,


intelligent,


and successful


(Butler,


1975).


spend


time with


older


clients


is frequently perceived


as the opposite


this


situation


and thus


is deemed


non-productive


both


in terms


client


progress


and monetary


payment s


(Fact


1978;


Mut schler,


1971).


It has been


estimated


that


approximately


three million


or over


13% of


.AL-n u .-..1n:~ 2.. -.- t fl na .w.r4ann -~1 b ~ 4, n rt o n to


Bn nt h a v


1~ nnllh


mnCnl


on nti naE










is projected


that, by


1980,


approximately


80% of those who


need


them


will not


ment al


health


services


(Fact


1978).


The mental


health needs


of older


persons


are not


substantially


different


from


those


of other


groups


but reflect


the difficulties


encountered


in any period


of marked


change


and adjustments


(Boyd


Oakes,


1973;


Buckley,


1972).


one


source


notes,


"Most


elderly


diagnosed


as having


fundamental


disturbances


can be helped


. most


of the difficulties


that


arise


are treatable with


minor


counseling


intervention"


(Fact,


1978,


167).


Yet,


despite


the substantial


numbers


of older persons


needing mental


health


services


and the relative


simplicity of their treatment,


the older population


receives


an estimated


less


than


2% of private


psychiatric


time and


about


2.3%


of total


out-


patient


psychiatric services


(Fact


1978).


Older persons


are in need


of supportive,


informational,


and empathetic


counseling


relationships,


these


kinds


of mental


health


services


are frequently


denied


them


the attitudes


of professionals


in the field


(Butler,


1976


Eisdorfer


& Altrocchi,


1961;


Fact,


1978;


Frankfather,


1977;


Garfinkel,


1975;


Mutschler,

the notion


1971).

that o


Garfinkel


ilder persons


found


are not


agreement


inclined


among her


subjects with


to be verbally


active


a relationship.


This


attitude,


notes,


leads


the therapist


assume


that working with


older persons will


not be productive.


Since


such patients


won't


"talk"


they


can


more


or less


legitimately


avoided.


As Garfinkel


states.


irony


of this


attitude


is that


trh nnniil n+inn mnct I.-


*1 l'Enin1


t n hnn oi f


fnmm


ciinn nrt 11 70o


~ffP~t"e


I 1 J











Compounding


the problem of


negative attitudes


toward


the elderly


and misconceptions


about


their potential


to benefit


from


treatment


the relative paucity


of theory


and practice


in the realm of


psychiatric


and mental


health


techniques


for working with


this


group.


It is noted


that


practitioners may


avoid


the older


client


partially


because


they


are ignorant


of appropriate methods


for use


with


them


(Bellak,


1976;


Fact,


1978;


Mutschler,


1971).


On the other


hand,


although


counseling


with


older persons


a relatively new


specialty,


most


sources


suggest


that


existing


techniques


and approaches


should


be adequate


to deal


with


the majority


of the older


clients'


problems.


The tendency


for mental


health workers


to overlook or


de-emphasize


the physical


and psycholo-


gical


causes


and influences


on older persons'


mental health


status


lead


erroneous


diagnoses


and nonproductive


treatment


(Boyd


Oakes,


1973;


Fact,


1978;


Mutschler,


1971).


Many


practitioners,


not unlike


most


laymen,


assume


. .that mental


or emotional


difficulties


are an


inevitable


product


of old


age.


. .these


negative


attitudes


can severely


limit


access


care


and,


access


achieved,


limit


the appropriate-


ness


of the


care


received


" (Fact,


1978, pp. 166-167).


Thus,


can be seen


that


older


persons


have


generally not


ceived


adequate mental


health


services,


despite


demonstrated


needs


responsiveness


to treatment.


Attitudinal


resistance


to working with


this


group


is partly


responsible


and apparently much


more


gerontological


ucation

d... n


a


is needed


for mental


~Y~nr: n a


i-


health


practitioners.


-% fi -S, U -- nf


A ma 14 nn An


Persistence

fin^ -Cat. 4-lc4n


stereo-


fl 4" 44 a..


can


re-


I


r











persons


and towards


the efficacy


of counseling


services


for them


crucial.


attitudes


of other


groups


of direct


service


providers


towards


the elderly


have


also


been


studied.


The general


category


social


worker will


be taken


to include


those


personnel


whose


functions


include


provision


a variety


of outreach


and social


services


aimed


at meeting


the health,


housing,


financial,


and other needs


of older


persons.


Generally,


those


are


the workers


have


the most


direct,


frequent


and personal


contact


with


older


persons


and who


are most


likely


to be


aware


of their


environmental


needs


and conditions.


many


cases,


they


are representative


a larger


bureaucracy


and the link


between the older

Obviously, then,


to the successful


person


and various


the attitudes


provision


levels


of direct


of assistance


of governmental


service


to older


providers


clients


agencies.

are important


(Pfeiffer,


1976).


Attitudes


of direct


service


social


workers


have


been


investigated


several


authors.


study


provides


examples


comments


made


social


workers


about


their


elderly


clients


and these


comments


enlightening.


As this


author


notes,


"These


workers


experience


conflict


between


their


traditional


roles


direct


services.


The worse


the client,


the less


likely


he is


et help.


one wants


the job


of direct


services"


(Frankfather,


1977


Several


comments


the subjects


in this


study


suggest


the difficult


of their


assignments


anrl the n prea 1itv


fnr mnrr


nPrsonnnsl


tn rin th-i


-I ~n pwp r 2


1


are


are


tP VP


HS


I









that'


what'


needed"


(Frankfather,


1977,


41).


These


duties


contrasted wit

arranging and


training


the geriatric


coordinating


and practice


social


services


are contributiv


workers'


traditional


the resulting

e to negative


role of


differences


views


between


of older


clients.


Another


geriatric


social


worker


commented,


"You


have


schizophrenics


depressed


people


need


therapy.


They


also


have


very


concrete needs--money,


housing,


food--as


well


as complex


personal


problems.


You don't


separate


one


from


the other.


There


aren't


services


to handle


both,


so you


do it"


(Frankfather,


1977,


40).


These


comments


are instructive,


for they


emphasize


several


points


relative


to the development


of stereotyped


views


older persons


the resulting lowered quality


of services


provided


them.


necessity


for meeting


the basic


human needs


of the elderly


apparent


and these


mus t


be satisfied


services.


That


prior


professionally


or simultaneous


trained


with


social


provision


workers must


of counseling

provide


direct


custodial


services


to older persons


as reported


Frankfather,


believed


to be wasteful


of their


expertise, and not


likely


to make


them


over-fond of


such


clients.


Social


workers


in consultation


with geron-


tological


counselors


might


enhance


both


their


abilities


to deal


with


these


realities


their


attitudes


towards


the aged


clients.


In another


study,


factors


were


reviewed


which


influence


the choices


perserverence


of work with


the aged among


social


workers,.


These


factors,


which


tended


to focus


on the negative


aspects


of older persons,


included


the low


status


of older persons


contemporary


society,


are











older


clients


(Mutschler,


1971).


It is suggested


that


these


same


factors


could


be influential


in determining


the choice


of other


pro-


fessionals


reducing


to work with


or eliminating


older


some


persons.


these


Counselors


influences


could


be useful


and in providing


overall


leadership


for enhancing


the attitudes


of all social


service


providers


towards


older


clients.


As Mutschler


notes,


"Thus


the low ranking


both


the client


group


and the therapeutic


techniques


associated


with


it by


fellow professionals


from entering


the field"


deter


social


(Mutschler,


workers,


1971


psychologists,


235).


In addition


etc.


to the


above


mentioned


influences


this


study


revealed


a stereotyped


view


older persons


attitude


as rigid


increased


and incapable


the professional's


of growth a

reluctance


nd insight

to enter


This


or remain


gerontological


service.


was further


noted


that


the underlying


fears


of death


and aging


held


the subjects


further


contributed


to the


reluctance


to work with older


persons


or to view


services


for them


beneficial


(Mutschler,


1971).


implications


of this


type


of study


suggest


that


workers


' attitudes


towards


clients


influence


both


quality


care


they


offer


and the


type


of services


believed


to be


appropriate.


Thus,


social


workers


believe


that


counseling


services


for older


persons may


be of little


use because


the elderly


lack


ability


to benefit


from


them


or because


the social


workers


themselves


are unaware


that


counseling


techniques


suitable


for this


type


of work


are available.





J











because


their


decisions


are crucial


to the development


of program policy


and implementation and


in the


case


of institutional


administrators,


the kind


study


and quality


Kasschau


servi


(1976)


ces


provided.


investigated


A particularly


the attitudes


comprehensive


and opinions


large


sample


trators


agency


dealt


with


business


the income,


and governmental


housing,


planners


transportation,


and adminis-


employment


and other needs


the elderly


Legislators who


voted


on relevant


bills


or served


on such


committees


concerned


with


aging needs


were


also


sur-


veyed.


These


subj


ects


were


chosen


part


because


"the


extent


to which


the elderly


are abl


to participate


in the


food


stamp


program or


able


find


housing


in the Model


Cities


Program is


often


largely


the function of


the discretionary


decision making powers


of these


top-level


administra-


tive agency


indicated


official


the existence


s" (Kasschau,


1976


of a number


. 16)


stereotyped


Results


views


of the study


of the elderly


However,


most


planners


believed


that


programs


and servi


ces


were


needed


for older


generally


persons.


felt


The deficiencies


to be the result


of social


services


of the attitudes


systems were


actions


of the


social


workers


and other


direct


care


providers.


subjects


were


also


concerned over


the increasing


amounts


of free


time


available


to older


persons


Even so


, they


frequently


failed


to consider


leisure


activities


in program planning or


the positive


effects


of such


activities


on the


health


of older persons


or their


abilities


to effectively


use this


time.


summary,


it would


seem


that


high


level


administrators


and policy


*- 1 r *


_1.


I 1










A diversity


of programming


and opportunities


for the older


person


become active


in the community was


noted


as was


need


for more


systematized


services


(Kasschau,


1976).


Another


study


investigated


attitudes


of nursing


home


administra-


tors


towards


older


persons


and services


for them.


Some


relationship


between


attitudes and


level


of subjects


' education


was


demonstrated


stronger


influences


were


shown


between


age,


sex,


and socio-economic


levels


of older residents.


As the author


notes,


"the


age of


clients


alone or


in combination


with


the effects


of other


status


characteristics,


also


influence


professional


recommendations


for their


care


or even


career


decisions


to work with


the aged"


(Keith,


1977,


465).


Thus,


it is suggested


on service


that


provision


attitudes

as those


of administrators


of direct


can be


care workers.


as influential

As another


author puts


"We now realize


the importance


a positive


attitude


toward


care


and rehabilitation


of the


aged.


In a


good


nursing


home


philosophy


care


projected


from


the administrator


through


all levels


of staff


is evident"


(Ernst


& Shore,


1975,


p. 5).


Another


paper


reviews


factors


influencing


both


policy makers


and the public


which


through


their


taxes must


support


programs


older


persons.


These


factors


include


aging


and the aged


are


viewed


and the level


of confidence


held


the public


and policy makers


in the


efficacy


programs


and services


(Vasey,


1975).


Vasey


states


problem well:


we do


not like


or approve


of the


neoDle


are


. .


i.&*v










spending money
restoration.


to provide measures of


policies will


more


treatment


likely


reflect
custody.


a preference for re


we believe


sidual


they


are


programs
too old


care


to learn,


will


probably not


want


to do much about


educational


programs


that


designed


research and


erase


the false


for them.
experience


Let me
which


stereotypes


that


emphatically


demolish


have


suggest


these myths


grown


around


aging and


on the conditions


elderly
of life


can have


for older


a profound


people


effect


and a telling


impact


on public


policy


(Vasey


1975,


This


statement


succinctly


summarizes


the prevailing


theme


this


literature


review,


that


attitudes


can and


do influence


program


planning


and service


delivery


for older


persons.


Although not


specifically


addressed


in the literature


it seems logical


to assume


that


counseling


services


for older


persons may


be viewed


a similar


light.


summary


it is suggested


that


a relationship


exists


between


misconceptions


about


the needs


and characteristics


of older


persons


and the quality

to the negative


type


attitudes


of social


held


servi


by workers


ces


provided


at all


them.


levels


In addition


the fears


aging


and death


represented


older


persons


serve


as strong


influences


on their mode of


dealing with


the elderly


and of the choice


to work


with


them.


That


there


a strong need


for counseling


and a viable


role


for counselors


' leadership


in interrupting


this


cycle


of negative


attitudes


poor


services


is evident.


This


need


an immediate


and

will


can


be expected


review


to increase


extent


to which


in the near

programs cu


future.


rrently


The next


section


address


counseling needs


of older


persons


in Florida.


one











Organization and


Fundin


For Older


g of Counseling Services
Persons


As has been


indicated,


the attitudes


of both


professionals


and the public


can


influence


the quality


of social


servi


ces


provided


to older persons.


Several


sources


have


commented


on the form or


organization


through


which


these


services


are delivered


to older


persons.


In general,


noted


that


service


programs


for today


older


persons


lack planning


and direction


focused


on realistically


meeting


their needs.


This


section


will


discuss


the criticisms


suggestions


offered


concerning


service


programs


for older


persons


the major


funding sources;


and organizational


structure


as it relates


to provision of


counseling


services.


A recurrent


theme


found


in discussions


of service


delivery


older persons


ary approach


relates


to meeting


to the need


their needs.


for a comprehensive,


one


source


multi-disciplin-


states,


elderly


patient


a problem


one area,


it is extremely


likely that


he will


have


problems


in other


areas


as well"


(Pfeiffer,


1976,


193)


This


author


further notes


that


the existence


of multiple


problems


among older


persons


frequently


compounded


because


they


lack


means


or the


resources


to reach


the different


locations


where


these


needs


can


be met.


The role


a service


coordinator


suggested


one who


could


facilitate


such


travel


for older


persons when a


central


facility


is unavailable


(Pfeiffer


1976)


ra


L,, L,,,


L\ 1 -AIln-C


u


I(r


r











been


implemented with considerable


success


in many


areas.


Such


centers,


however,


not generally


provide


screenings nor


do they


administer


social s

included


service p

in this


programs.

type of


Counseling


setting


servi


ces


or as a base


could


be logically


for conducting


outreach


counseling


(Sylvester,


1976)


Boyd


Oakes


further note


that


concept


comprehensive


services


depends


on a recognition


that,


many


older


persons,


economic


and social


needs


are as pressing as


medical


ones.


The organizational


barriers


encountered


the elderly


are noted as


more


formidable


when


seeking


these


kinds


of services.


stated,


"Likewi


, a person


with an


emotional


problem


or psychiatric


illness


should


receive


or appropriate


help


as soon as


p055


ible


without


having


go through all


sorts of


unnecessary


channels


(Boyd


& Oakes,


1973,


140)


These authors


suggest


a central


service


agency


for older


persons


which


includes


an information


and referral


service,


diagnostic


center


and a "well-aging"


clinic.


The emphasis


in this approach would


on prevention,


particularly with


regard


mental


health


concerns


(Boyd


& Oakes,


1973).


summary,


those


authors


have


investigated


attitudes


towards


aging


older


persons


tend


to note


the need


for a comprehensive


center


for services designed


to meet


multiple


needs


The bureaucratic


barriers


are also

advocate


imposed


cited


, a guide


n p-a I1 a n


governmentally


hindrances


funded


in meeting


or a coordinator


4 n~


to lead


a


and/or


these


administered


needs.


older

r 4-. ^-J -& -


person

UrTLa-


programs


The need


through


I- a- -1


a a A n an n -


-


A











recipients


is not


solely


aimed


at the elderly;


however


the negative


view with


this


which older


tendency


persons


Providing


are seen


professional


believed


and social


to further


service


strengthen


workers


with


greater


knowledge about


older


persons


will


not automatically


reduce negative


attitudes


or improve


services.


As Mower notes,


"Understanding aging processes


does


not necessarily


guarantee


that


will


approach an


older


person


a different


manner


However,


through


this

aged


understanding,

while negative


positive

behavior,


behavior


which actually


staff members may


impedes


encour-


the independence


the aged,


be reduced"


(Mower


Shore,


1975,


The literature


seems


to emphasize


that


comprehensive


services


for older


persons


are needed


and that


negative attitudes


towards


aged


can limit


the effectiveness


of exis


ting


programs


the develop-


ment


new


ones.


As Butler


has noted,


"We know what


services


older


people need and


that


these


needs


are extensive.


The financing


logistical


problems


are not insoluble.


Now,


however


services


of all


kinds


for old people are


fragmented,


limited


, discriminatory,


inacces-


sible


or non-existent.


When


services


are available


e. their


quality


questionable"


(Butler,


1975,


140).


comment


suggests


it is


necessary

become fa


and helpful


miliar with


for counselors

the legislation


concerned

sources


with older

of funding,


persons


and organiza-


tion


of service


programs


for older


persons.


The Older


Americans


of 1965


with


its subsequent


amendments


a1


..L 42..Zfl7


- ~~~~~ ~ ~ ,* t~l -- -. -l-a 4-nd tt A r


one


LI\nL


Ckn


I











does not


rate


one of these


four


areas


of need


ahead


of another;


housing,

services


transportation,

are given equal


homemaker,

stature in


and 1


egal


the Act


and other


(H.E.W.


197


counseling

5). Addition-


ally,


the Act


does


not specifically


require


that


each of


the four


areas


of need


be addressed


equally.


State


governments


are only


required


"provide


for the establishment


or maintenance


programs


[including


related


training]


for the


provision


some or


all,


of the


following


servi


ces" (H.E.W


1975,


Thus,


can be


seen


that


state


local


governments


could


concentrate


their


efforts


solely


on one or more


services


to the exclusion of


the others,


still


be in technical


compliance with


presents


the Act.


a problem with


Additionally,


respect


the wording


to counseling


of the Act


services.


further


Personal


counseling


services


are included


a statement


that


seems


to emphasize


legal


counseling.


appears


that


the Older


Americans


Act makes


it possible


programs


to be developed which may meet


some


not all needs


older


persons.


This


precisely


the kind


of fragmented


, incomplete


service


program


result


which


of this


was


wording


criticized


by previously


has led to varied


reviewed authors.


interpretations


of the


intent


of the legislation.


Apparently many


states,


including


Florida,


were

areas


considered to

. A directive


be providing


from


inadequate


the Administration


attention

on Aging


to all p

recently


priority

sought


to clarify


this


portion


of the 1965


Act.


As i


stated,


"Despite


t4r rf- lr l 1on1r nT ,i a


-r It


iL!t nr~l


tlrdt


;nt ~rnrafat; nn


n T


in rt~F~tO~


JLi A --m


, ,--


rnn rorm cnmo


n











focus


on the national


priorities


service,


but that


counseling


services


were


not listed


among


them.


statement,


"legal


and other


counseling


services,


was reduced


to legal


services


only


(H.E.W.,


1977).


Those


concerned


with


counseling


services


for older


persons


need


to be


aware


of these


legislative


provis ions


and their


interpretation.


Attention

counseling


should be directed

services receives


towards

an equal


insuring

share o


that


the full


f funding


range


program


development


states.


To assist


in the effort


to meet


the counseling


needs


of older


persons,

adequate


a legislative

counseling se


bill


rvices


was


developed


for the


in 1977


elderly.


This


aimed


at providing


proposal,


(HR1118:


Guidance


and Counseling


for the Elderly)


outlines


a comprehensive


counseling program


for older


persons.


Counseling


in this


instance was


defined


as "the


process


through


which


a trained


counselor


assists


individual


or group


to make


satisfying


and responsible


decisions


con-


cerning


personal,


educational,


social,


and vocational


development"


(U.S.,


1977,


. 36).


Inclusion


of this


or a similar


definition


in the


portion


of the Older


Americans


Act dealing with


the priority


services


would


have


perhaps


given


counseling


a clearer


identity


and stronger


position


relative


to other


priority


services.


Regretfully


this


bill


not been


passed.


Federal


funds


for Older


Americans


programs


are provided


*1_


- A- S --


tHl~m ut to n l c nn Mn c


thP Tm ri nlle


th mtloh


rpntr~]


ct~tPE


ctstP


rf-


W1 r, n ~Fnr











Services


which


was re-organized


in 1975.


purpose


of this


change was


to "integrate


the delivery


of all health,


social, and


rehabilitative


services


(Florida,


offered by


1978a,


state


112)


to those


Thus,


citizens


the intent


was


in need


to provide


of assistance"


type


comprehensive


service


delivery


system


that


previously mentioned


authors


felt


was


best


suited


for meeting


the needs


of older persons.


success


However,

of Aging


of this


the shift

and Adult


re-organization


did lead

Services,


not been


thoroughly


to the establishment


which


evaluated


a separate


has the major responsibility


office

for


admini


station


of all aging


programs.


current


(1978-79)


Florida


State Plan


on Aging outlines


several


overall


objectives.


Of particular


relevance


to counseling


is the


statement


that


the State


will


develop


program standards


for a minimum


of three


social


service programs


funded


under Older


Americans


auspices.


Thus


more


emphasis


a greater number


of the priority


services


is anticipated


(Florida,


1978c).


More


specific


to counseling


is the proposed


obj ective


to provide


counseling


services


to a minimum of


23,538


older


persons


statewide.


These


services


will


include


assistance


with


psychological,


family


and social


concerns


to be "explored


within


the confines


a confidential


relationship with


trained


professionals


leading


an improved


sense


of mental


well-being


for the elderly


per-


sons


" (Florida,


1978c,


It is


apparent


that


a great


deal


more


than


legal


advice


is implied


in this


statement.


proposed


priori-


*,~~~~~~~~~~~~~~ at ~ r nF14 A An +, n CD 4- finC.. nn C-- 4 3.-


tinn


Fnr ~ln r: ~n


nn nrltl~nh ij


,,f ,


rr EfUc,


*C Yllf~r.











Plan


for Florida


gave


increased


attention


to counseling needs


servi


ces.


review


on the relationship


of literature


between


pertinent


attitudes


to thi


towards


study


older persons


focused


and servi


provided


for them.


Areas


of general


need


and characteristic


commonly


associated


with


older persons were


discussed with


emphasis


on the


probable


origins


of prevalent


active


stereotypes


about


the elderly


Attitudes


of various


social


servi


and health


professionals


were


shown


to be largely


negative


to have


an effect


on the quality


care


servi


ces


provided


to older


persons


Program planners


and administrators


attitudes were


also


examined with


attention


to their


roles


in service


delivery


to the elderly.


Possible


roles


of counseling


servi


ces


programs


for older


persons were


reviewed and


was


indicated


such


services


should


be given


greater


emphasis


both


administrators


and direct


servi


providers.


It is


apparent


that


there


a need


assess


extent


to which


these


predominantly negative


impressions


influence


the attitudes


held


workers


towards


counseling


services


for older persons,


Although


counseling has


implementation


been


of this


established


goal


as a national


not been


and state priority,


achieved


full


in Florida.


the literature


suggests


negative


attitudes


influence


servi


delivery,


then


it is important


that


this be established


with


respect


to counsel-


From


this informational


base,


appropriate


corrective


plans


hea dpv o1 nnr


ti r\ nPri a ni A


,n nin-rn-a


ces


can


hnth


slttitll~ac


nlri~r


CO r~ll ~P


















CHAPTER


METHODOLOGY


The results


of the literature


review


indicate


that


little


been


done


to develop


counseling


services


as components


of aging pro-


grams


in Florida


priority,


programming


and in the nation.


counseling


in Florida


has received


(Florida,


Of the four


the least


services


emphasis


1978a,


given


in funding


purpose


of this


national

and


study


was to determine


the perceptions


towards


counseling


services


for older


persons


held


selected


employees


of the Florida


Health


and Rehabilita-


tive


Services


Aging


and Adult


Services


Program Staff,


study


also


attempted


assess


the relationship


between


the perceptions


or at-


titudes


services


held


Administrators


offered


for older


and Direct


persons


Service


the relative


Personnel


toward


importance


given


to counseling


Aging Program developers,


administrators,


and direct


service


personnel.


This


information


then


serve


as a baseline


from


which


strategies


and plans


for funding


and implementation


of specialized


counseling


services


for older persons


be made.


The research


questions


did the subjects


investigated


define


this


counseling


study

and how


included:

did they


A4Ffarn F 4n r' ntr r AFn~rrnn


rliF Far in


T-


n 1 s











did subjects


perceive


counseling


in relation


to other


services


provided


programs


for older persons,


and how


did they


differ


in their perceptions?


did subjects


services


evaluate


in aging projects


current


programs


status


of counseling


and how did


they


differ


in their


evaluations?


did subjects


ability with

of the aged,


rat e


respect


counseling


their


own level


needs

services


of knowledge


of the aged,

and technique


characteristics

es for the


elderly


client,


did they


differ


in their


self-ratings?


Instrumentation


As the literature


review


indicates,


there


are no instruments


currently


available


which


adequately


assess


the perceptions


of aging


program personnel


towards


counseling


services


for older persons.


Several


instruments


evaluated


attitudes


towards


aging


and toward


older


persons


however,


these were


not sufficiently


specific


for the


purposes


of this


study.


Consequently,


a new


instrument


was


developed


researcher


based


on the literature


review


and discussions with


appro-


private


Aging Program staff


and faculty


at the University


of Florida.


The following


actions


describe


the development


of this


instrument


steps


planned


assure


its validity


and reliability.


First,


five


maj or


areas


were


selected


for investigation.


These


-. -n A. .. .


i.. 1 1 ii


- -


/-


~un~n









Definition of


Role


Counseling


of Counseling/Counselors


Counseling


Current
Level o


Second


in Relation


Status


to Other


of Counseling


f Knowledge


the conceptual


Services


Services


Counseling


validation of


and Aging)


the comprehensiveness


importance of


these


five


areas was


accomplished.


researcher


identified


and contacted


ten professionals


currently


employed


in the


Florida


Program.


Health


Four


and Rehabilitative


administrative


Services


personnel,


Aging and


five direct


Adult


service


Services


staff,


one from the


State


Office


in Tallahassee,


were


selected.


These


indivi-


duals


were


representative


of the three


groups


from which


the larger


sample


of subjects


was finally


drawn.


A member


of the University


Florida


Counselor


Education


faculty,


skilled


in instrument


development,


was asked


to participate


in this


procedure.


Each


person was


asked


review


comment


on the five


areas


proposed


for development


in the


questionnaire.


interviews,

participants


Comments were


or written


received


communications


The researcher


compiled


telephone,


between

these


face-to-face


the researcher and th

comments .and developed


questions


based


on their


content.


These


topics


provided


the basis


from


which


the initial


draft


of the questionnaire was


developed.


Approxi-


mately


ten question


items were


developed


in each


of the five


areas,


suggested


the reviewers'


comment s.


first


draft


of the instrument


was


presented


to the reviewers


for the


purpose


of obtaining


additional


comments


on the


content,


wording,


and format.


a result


of their


appraisals


approximately


one-half











These


personnel


were


asked


to review


comment


on the revised


instru-


ment,


which


they


had not


previously


read.


Their


comments


and suggestions


were


incorporated


into


those


previously


obtained.


A final


version


the instrument


was developed


consisting


of 61 items


related


to the


original


five major


component


areas.


Items


1-60


followed


the Likert


scale


response


instrument


was


format;

then re


item


was


.submitted


an open-ended


to both


reviewing


question.


groups


revised


comment


(Appendix A).


A third


group


ten reviewers


with


same


classifications


as the first


and second


groups


had not


seen


previous


versions


the questionnaire


was


chosen


to participate


in this


procedure.


Com-


ments


were


solicited


regarding


appropriateness


of form,


content,


readability,


language,


clarity,


length


of time


needed


to complete,


types


of demographic


data


requested.


The results


of these


three


reviews


indicated


that


commen-


tators


agreed


that


the terminology


utilized


was


appropriate


for the


topics.


questions


were


stated


terms


which were


familiar


to them


and which


were


felt


to be suitable


for the proposed


subjects.


instructions

and clear.


demographic


No further


data,


changes


and format


were


were


suggested


considered


appropriate


the reviewers.


procedures


involved


in the development


review


and revision


of the


instrument


were


accomplished


during


a three


month


time


period.


These


methods


established


the conceptual


content


validity


of the instru-


-] I-4-,


IIEm mT 1 1I










HRS and the State Program Office,


were


chosen


to represent


larger


sample


identified


for the study.


Figure


illustrates


geographic


division of


the 11 HRS districts


in Florida.


These


subj ects


included administrators


of aging


programs


direct


service


supervisors


and social


workers,


and purchase


of service


staff.


Additionally,


variations


level


of education,


sex,


race


were


analyzed,


noted


in Table


Table


indicates


work locations,


sex and


race


the 30 selected subjects.


The instrument


was administered


to the subjects


at their work


sites


in each


district,


in the State


Program Office,


searcher,


using


the Standardized


Procedures


for Administration


of the


Questionnaire


(Appendix B).


After


a two week


interval,


the instrument


was readministered


same


group


of subjects


at their work


locations


the researcher.


Responses


from


these


two administrations


were


analyzed


to determine


reliability


co-efficient


of each


item included


in the instrument


shown


in Table


Fifty-eight


of the items


were


statistically


signifi-


cant


at the


.01 level


and items


21 and 57


were


significant


at the


level.


The data


for the reliability


study were


analyzed


employing


Statistical Package


for the Social


Sciences


Program


for correlation


analysis


acceptable

items. Ac


using


level


cordingly,


the Pearson


r statistic.


of reliability


the instrument


originally


or better was


in its final


selected


met by


form was


all 60


used


statewide


administration.


re-



























Inr
'U~a


J as


& ~










TABLE


LEVEL


OF EDUCATION OF TEST


RETEST


SAMPLE


BY SEX AND


RACE


Level


Sex and Race


Total


Education


Male


Female


Ethni


Ethnic


White


Minority


White


Minority


Total


Grades


High


0-11


School


10.0


A.A.


16.7


Degree


Year


College


Degree


20.0


33.3


56.7


. Master


s Degree


13.3


20.0


Total


Total


26.7


60.0


13.3


100.0


Total


Male


Female


Category


and %


26.7


73.3


Caucasian


Ethnic


86.7


Minority


13.3






57



TABLE 2


WORK LOCATION
BY


OF TEST
SEX AND


RETEST
RACE


SAMPLE


Work


Sex and Race


Total


Location

%


Male
Ethnic


White


Minority


Female
Ethnic


White


Minority


Total


District


District


4
13.3


District


4
13.3


14
46.7


20
66.7


District


0
3 0.0


State


Office


0
3 0.0


3
10.0


Total
%o


18
60.0


4
13.3


30
100.0






58





TABLE 3

MEAN, STANDARD DEVIATION AND TEST RETEST CORRELATION
COEFFICIENTS FOR PILOT TEST


Item


Item


Number


Mean


S.D.


Number


Mean


S.D.


1.47

1.83

1.83
2.33

2.37

1.87
1.60

1.57

1.33

1.47
1.80

1.83

1.70
1.63

1.93


1.03


.58**
.80**

.93**

.88**

.91**

.83**
.75**
.72**

.78**
.87**

.76**
.74**

.88**
.83**
.66**


3.10

3.17

1.57

2.00

2.77

3.67

1.83


1.06

1.02


.71**

.58**

.77**
.75**

.67**


.38*


1.09


1.02


3.30


.83**

.75**

.72**

.63**

.71**
.71**

.79**

.55**
.76**






59



TABLE 3--continued


Item


Item


Number


Mean


S.D.


Number


Mean


S.D.


.92

1.04

.90

.79

.84

.73


1.90


.72**
.75**

.64**

.74**

.66**

.79**

.84**

.70**

.80**

.80**

.68**

.78**

.76**

.83**

.66**


1.63


.64**

.61**
.78**

.77**

.83**

.60**

.84**

.66**

.75**

.61**

.76**


.38*


1.70


2.17

2.33


3.47


.66**

.53**

.80**


Summary:


Mean


Range of Mean
Range of S.D.


= 1.47


- 3.67
- 1.09


Pearson r


Mean
Media


Range


S.D.


Mode


.66,


.75,


S.E.M


p < .01
+ two week interval










Subjects


and Selection


of Sample


Selection


of subjects


to participate


in this


study was


based


the following


considerations.


Subjects


were


selected


from


current


employees


of the Florida Department


Health and


Rehabilitative


Services


Aging


and Adult


Services


Program staff.


It was


considered


important


assess


the perceptions of


these


groups


because


their


responsibilities


services

funds al


include


programs


located


the planning,


for Florida's


for expenditure


funding,


and implementation


older population.


in aging


programs


in Florid


federal

a are ad-


ministered


or monitored


the Florida


Department


of Health


habilitative


Services.


attitudes


HRS employees


towards


counseling


services


for older


persons were deemed


crucial


to the planning,


plementation,


administration,


and monitoring


of these


programs.


Subjects


were organized


studied


category


researcher


identified


three major


groups


from


which subjects were


selected.


These


included:


Category
Category


Administrators of


Direct
Workers


Service


Aging


Programs


Casework Supervisors


Social


Category


Purchase


of Service


Staff


In Category One were


all professional


State


Program Office


staff

staff


District


in Florida.


Program Office


Included


staff,


in this


and Areawide


category were


Agency


on Aging


the State Aging


Adult


Services


Program Office


Director,


Program Administrators,


Progrnm glner'in i qt-q.


Pi r-rncran Cn4 nl -^ flw. a nm


n; ctriFt


nYn rr yr nm


f\ % /











category


This number


changes


frequently


due to routine


personnel


changes

staff a


position


ttrition.


additions

Included


and deletions,

in Category One


budget


were


limitations,


persons


and normal


employed


in the State Aging


and Adult


Services


Program


Office


(PDAA)


in Tal-


lahassee,


persons


employed


in the 11 district Aging


and Adult


Services


Program


Offices,


and 55


persons


employed


in the


ten Areawide


Agencies


on Aging


statewide.


attempt


survey


all 128 of


these


persons was made and


were


surveyed.


Persons


in thi


group


have


policy-making authority


in aging


programs


in Florida,


and determine


funding


and programming


priorities.


Thus,


this


group


direct


impact


on provision of


second


services


category


and fund


consisted


expenditure.


of Specialized Adult


Service


Direct


Service


Casework Supervisors


Social


Workers who


were


sampled, using a


random


select ion


procedure.


There were


approximately


persons


in this


group


in Florida.


This number


changes


frequently


due to the


reasons


cited


for Category


One.


In each


of the 11 Health


and Rehabilitative


Services


Districts


in Florida,


ten individual


Aging


and Adult


Servi


ces


Specialized Adult


Services


Casework


Supervisors


Social


Workers


(SAS)


and three


alternates


were


selected


for a total


of 143 subjects


in this


category


There


were


134 subjects


from


this


group


event


surveyed.


The three


one or more of


alternates were


ten primary


subjects


selected


were


for use


absent


in the


on the day


the instrument


was


administered.


During


the actual


administ ration,


, A.- *1-a


-. -In


1 *


.1


.1


r


.r r.


..J











to the Aging


and Adult


Services


Specialized Adult


Services


category


position number)


was


reviewed,


each


position


entity on


the listing


was assigned


a number


from a


table


of random numbers


(Downie


Heath,


1970


328-329)


. A second


table


of random


numbers


was


used


to select


those numbers


from each of


the 11


districts)


which were


surveyed


as primary


(ten)


and alternate


(three)


subjects.


Category Three


included


Health


and Rehabilitative


Services


Purchase


of Service Project


Directors


and staff


(POS)


Included


this


Category were


portation


service


other project


staff


Project

providers


There


Directors,

. outreach


meal


program directors,


coordinators,


are currently more


than


homemakers,


220 proj


trans-

and


ects


Florida


of which


provide


counseling


services


(Appendix


same


random selection


procedures


described


for Category Two


were


used


in sample


selection


for Category Three.


There


were


approximately


1,300


Purchase


of Service


Project


staff


in Florida


were


employed


approximately


220 projects


statewide.


total


number


of projects


and project


staff


fluctuates


to funding availability.


Category


Three


consisted


ten primary


three


alternate


Purchase


of Service


project


staff


from


each


of the 11 districts


for a total


of 143


persons.


A total


persons


from


this


group were surveyed.


Total


subjects


contacted


for the study was


persons.


total


included


128 in Category One;


143 in Category Two;


and 143 in


Category


Three.


There


were


373 questionnaires


completed


at ,. -C.


*tVL- 1 -- ------


-----1


use


--U-E1


d


r


r


.T A









rural/urban geographic


location.


A listing


services


older


persons


provided


these Aging


Program


Staff


shown


in Appendix


The minimum acceptable


total


sample


size


was


300 which


repre-


sented a


72% rate of


return.


A minimum of


100 subjects


was


expected


in each


of the three


categories.


N of 373 which


was achieved


represented


a 90.1%


rate of


return.


procedure of


sampling


location and


position


resulted


in the distribution


of subjects


shown


in Table


Procedures


following


procedures


were


developed


for the administration


of the questionnaire,


to insure


confidentiality,


assurances


cooperation,


follow-up methods,


and other


considerations


relevant


the implementation


of the study


The researcher


developed


a form


to insure


that


each


participant


was made


aware


of the


purpose


of the study


of the confidentiality


of the data


gathered


(Appendix A)


form was


approved


Human


Subjects


for each


Review


subject


Board at


as a part


the University


of Florida,


of the questionnaire


was


packet.


provided


Questions


regarding confidentiality were


answered


by the


researcher


at each


administration


site,


of the Questionnaire


instrument


the Standardized


were


followed


. Each participant's


Procedures


at all administrations


signature


on the form


for Administration


of the


indicated


voluntary


participation


in the study.


























Ce" ~~cO O\N lc


rH O


Oerj


'no


0304c~


LflVH(


004~


rO


'no


-40


cO N


O N


[r\ CJ


rS ri


rl O


O


O O


rl O

























Nt4 O


r40O


r-IO


c~j0


CNCI


o\C J


tfl,-I


r-r-


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tn C~'


-4-4f


trH


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was given


verbally


and a written


statement


to this


effect


obtained.


This


endorsement


of the study was


made


available


to the subjects


referenced


the researcher when


contacting


participants


for the study.


The researcher


announce d


the study


at the statewide meeting


of Aging


and Adult


Services


administrative


staff


in November


1978.


this


means,


the cooperation


support


of each


of the 11 HRS Aging


Adult


Services


Program Supervisors were


obtained.


Administration


of the questionnaire was


accomplished


methods.


First,


the researcher


administered


the questionnaire


personal-


at nine


work


sites;


and second,


questionnaires


were


mailed


when


impossible


for the researcher


to visit


work sites


personally.


With


both


methods,


the Standardized


Procedures


for Administration


of the


Questionnaire were


used


exclusively


to insure


uniformity


of administra-


tion.


visits


to the districts


and State Program


Office


were


pre-


ceeded


letters


the proposed


date


to the participants


mailed


of the administration,


which


two weeks


was


in advance


previously


agreed


upon


telephone


contact


with


the district


Aging


and Adult


Services


Program Supervisor


or Specialist.


A telephone


call


was


made


to the


district


Program Office


one week


in advance


of the visit


as a final


reminder.


The researcher


contacted


each HRS


District


Office


and the State


Agin


and Adult


Services


Program Office


for the


purposes


of administer-


was


-











field


staff


at the


same


location and


time


in all instances.


This


group


administration

questionnaire


was


accomplished


at the time


scheduling


of regularly


scheduled


the administration


district-wide meetings


for the


prupose


of reducing


travel


cost


and time


investment


participants.


Questionnaire


administration


was conducted


in the


District


headquarters'


building


conference


room or


Areawide


Agency


Aging


conference


room,


in all


cases.


Questionnaires


were


completed


no less


than


10 and


no more


than


30 minutes


in all


cases.


percent


of return of


the districts


the questionnaires


having Areawide


was


90.1


Agencies


for the statewide


on Aging,


sample.


the HRS district


headquarter


s office


is located


in the


same


city


as the Areawide


Agency


on Aging


in all


cases


, enabling


the researcher


to visit


both


agencies


with minimal


travel


between


offices.


In those


two districts


where


the researcher was


unable


schedule


an on-site


visit,


the Aging


and Adult


Services


Program Super-


visor


or Specialist


for the district


was


trained


telephone


prior


the administration


of the questionnaire


in the administration


of the


questionnaire


using


the Standardized


Procedures


for Administration


the Questionnaire


(Appendix


questions


were


answered


potential


problems


discussed


at that


time.


researcher


then mailed


the questionnaires


to the district


Program Supervisor with


each


questionnaire


identified


the position


number


of the


person


to whom


was to be administered.


A listing


of the Standardized


Procedures


a C a-. -., fl s--A-'.


Fn* A rlmJ ~: ncue ~ ,,


d


r


1^


L


I










Following


collection


and analysis


of the data,


results


of the


research


were


provided


to the participants.


A summary


of the results


of the study was


mailed


to the State


Aging


and Adult


Services


Program


Office


and to each


district


Aging


and Adult


Services


Program Office


and Areawide Agency


on Aging.


subjects were


mailed


a copy


of the


summary


of the results


the study


and copies


of the discussion


section


of the study.


Data


Analysis


After


the questionnaires


were


administered


and collected,


resulting


data


were


prepared


for statistical


analysis.


All question-


naires


with


no less


than


75% of the items


completed


of the possible


61 items)


were


researcher


considered

transferred


complete

the data


for the

from t


purposes


of the analysis.


he 373 completed


questionnaires


to computer


coding


be key punched


onto


forms.

data


Arrangements


cards


were


and prepared


then made


computer


for the data


analysis.


Appropriate


computer programs


for the desired


statistical


analyses


were


selected


from


the Statistical


Package


for the Social


Sciences


Program Guidelines


(Nie,


1970).


The main


purpose of


this


study


was to determine what


perceptions


Aging


Program Staff


in Florida


held


regarding


counseling


services


older persons.


In order


to determine


what these


perceptions


for the


total


sample studied


were,


the mean


and standard


deviation


response


each


item were


calculated.


Frequency


counts


were


calculated


to deter-










accomplished

groups of su


determine


to determine


objects.


the degree


if differences


The Pearsonian


of relationship


were


r correlation


between


significant


was


between


calculated


the demographic


items


test


items.


The Alpha


level


.05 was


chosen


to represent


statistical


significant


significance.


differences


Levels


were


were


calculated


also


and reported


reported.


as they


Non-


occurred


in various


categories


of interest.


Responses


to the open-ended


items


on the instrument


were


tabulated manually


to determine


nature


range


of their


content.


Results


obtained


for these


items


are reported


in Chapter


Limitations


of the Study


References


dealing with


research


design


denote


several


factors


which may


limit


the valid


interpretation


of results


(Campbell


Stanley,


1963;


Isaac


& Michael,


1971)


In connection


with


this


study,


several


factors


should


be noted which may


have


affected


its validity


and the usefulness


of its results.


Bias


have


been


introduced


through


the selection


procedures


used.


Although


subjects


were


randomly


chosen,


there


have


been


other


factors


which


determined


those


subjects


actually participated


in and completed


the study.


Since


participation


was voluntary,


there


have


been


differences


between


those who


chose


to join


in the study


and those who


did not.


Addit i onal


hias may


h snw


bee~n


intrnrlodird


n 1PrPrpe-linc


thP natnal











of the topic,


of their


performance with


respect


to counseling,


their


attitudes


towards


However,


prior notification was


essential


to insure


adequate


participation.


No methods


of determining


the effects


of this


procedure


appeared


feasible


for this


research.


Pre-existing


attitudes may


have


also


influenced


the perceptions


of subjects


toward


counseling


services.


However,


use of the federal-


state


term by


ceptions


definition


of counseling


all subjects.


largely


Otherwise,


constituted


insured


a standard


previously


type


held


of information


interpretation


attitudes


which was


of the


per-


sought.


Threats


to the external


validity


and generalizability


of this


research may


have


been


generated


from several


sources.


As noted


pre-


viously,


the attitudes


of participants


in Florida may


differ


signifi-


cantly fr

sequently


om persons


in similar


generalizations


positions


beyond


this


in other


locations.


population may


Con-


be limited.


How-


ever,


it is believed


that


the sampling


of the diverse


geographic


population


sites


in Florida


should


have minimized


this


problem.


addition,


although


there


are organizational


differences


among


states,


the administration


of aging


programs


and funds


across


nation


Aging


is probably more


are part


alike


of a nationwide


than


not.


structure


Areawide


and are


Agencies


similar


in many


respects.


The possible


reactive


effects


of the research


procedures


them-


selves


have


had an effect


on some


participants.


presence


trhno nitool-- rnnn, n f


t hrr rrr~a rr rrhnr


nn13 Wk n


hnth


?I rlm;n i c t ~ ra rl


snn











or small


group


discussions


on the subject


of counseling


services


older persons.


Although


was


stressed


that


participation


voluntary


some


subjects


have


felt


an obligation


to participate,


and this


sense


of obligation may


have


some


influence


on responses.


As much


as possible,


the researcher


administered


the questionnaire


same


the effects


identical.


that


manner


possible


at each


procedural


location


an effort


variations


have


to reduce


introduced.


It is also


noted


that


changes


in staffing


patterns


nomenclature


for HRS positions


are under


consideration


currently,


reviewed


in Appendix


While


position


descriptions


and educational


requirements


"Social


remain


Worker


unchanged,


Counselor.


the job


" Should


titles


these


be changed


changes


from


occur,


definitions


of counseling and


the assignment


of duties


which


fall


under


this


definition might


chan


Such


alterations


could


affect


future


attitudes


towards


counseling


held


employees


in these


positions.


was


















CHAPTER :

RESULTS


results


of the data


analysis


as described


in Chapter


III,


are discussed


resulting


in this


sample,


chapter


analysis


following


of individual


topi


questionnaire


are included:


items


responses


and discussion


of the results


terms


of the research


questions.


with


Analytical


the discussion


table


pertinent


and additional


data


to these


tabl


topics


are inclu


are presented

ded in the


appendi


ces.


Significant


items


or those


of particular


interest


noted and


discussed


in detail.


Responses


to the open-ended


Item 61


are reviewed.


Resulting


Sample


As indicated


in Chapter


III, completed


questionnaires were


obtained


from


373 Aging Program Staff


in Florida.


Responses


to the


demographic


information section


of the instrument


form


the basis


this discussion.


Table


presents


a summary


of all sample


demographic


characteristic


CS.


following


discussion


examines


major


components


of these


factors.


are










TABLE


SUMMARY


OF DEMOGRAPHIC


CHARACTERISTICS OF


SAMPLE


Characteristic N % Total



1. Age
Under 25 17 4.6
25-35 157 42.2
36-45 62 16.7
46-55 79 21.2
56-60 32 8.6
61-70 21 5.6
71-80 4 1.1
Over 80 0 0.0

2. Sex
Male 103 27.7
Female 269 72.3

3. Race
Caucasian 323 86.6
Ethnic Minority 50 13.4










TABLE


5--Continued


Characteristic N % Total


Work


Location


District
District
District
District
District


District VI


strict


District VIII
District IX
District X
District XI


State


Program Office


Education
Completed


Grades


0-11


High


School


Graduate


13.7


Associate


Four


Master'


Ed.S.
Ph.D.
Other


Arts


Year Coll


Degree


Graduate


53.0
24.5


Degree


Degree


Subject


in Which


Highest


Degree was


Earned


Administration
Counseling


Social


Work


25.2


Gerontology
Psychology
Sociology
Other


43.7










TABLE


5--Continued


Characteristic N % Total


resent


Position


Title


State


Program Office


District


Area Agency


Aging


Project


Program Office


on Aging


Staff


Staff


Specialized Adult


Services


Staff


12.1
33.1
36.0


Number


of Years


in Present


position


Less


than


years


Lz- years
6-10 years


11-15
16-25
26-35
Over


41.9
37.1
12.1


years
years
years


years


Special


Training


or Experience


in Working with Older


Persons


63.9
36.1


10. Special


Training


or Experience


in Counseling


55.8
44.2


Staff










younger


than


years.


It is of interest


that


only


6.7%


of these


employees


were


years


or older


Most


subj


ects


fell


in the 25-35


year


age range


with


persons,


representing


42.2%


of the total


sample,


occurring


in this


range.


smallest


numbers


were


found


among


the oldest


group,


the 71-80


years


old,


with


four persons


the total


sample


in this


range.


Sex and Race


sample


women;


and 27.7% m


was predominantly

lale. Similarly,


female:

a large


72.3%


majority


the subjects


of parti


were


cipants


were


Caucasian;


86.6%.


The remaining


13.4% described


themselves


representing an


Educational


ethnic minority


Level


The educational


level


fessional


fields of


the subjects


provided an


interesting


profile.


Overall,


the sample


was well-


educated,


with more


than


half


reporting


completion


of a four


year


college


degree.


Associate


of Arts


grees


or less


education


reported


19.6% of the


group.


Advanced


degrees


were


held


27.9%


of the sample.


terms


had degrees


area


in social


specialization


work


or academic


and several


major,


in Sociology


most


Degrees


administration


were


reported


8.3%


Least


represented


were


counseling


and gerontoloev(


Among


those with advanced


degrees


four


was


re 7 IV


\ rvrul











degrees


in education


nursing


nutrition


and criminal


, history


justice


music


Two or fewer


education


subjects


also


reported


grees


in each


of the following


academic


areas:


urban


planning,


fine


arts


, humanities,


anthropology


recreation


therapy,


speech,


art,


public


relations,


Spanish, zoology


and business


administration.


Job Classification


Sample


participants


the aging network.


The Agi


represented

ng and Adult


the various job

Services State


categories


Program Office


in Tallahassee


comprised


or 24


persons.


At the District


level,


and Adult


Services


Staff


totalled


persons


or 9.7


Area-


wide


Agency


on Aging


programs


were


represented


persons


or 12.1%


of the sample

the total.


Aging


Specialize


project

d Adult


staff in

Services


eluded


employees


persons

composed


or 33.1%


the remaining


36.0%


or 135 subjects.


Number


of Years


Worked


Those


subjects


reporting


less


than


years


in their


current


classifications


represented


41.9%


of the total,


or 156


persons.


Those


working


from


two to five


years


included


138 subjects


or 37.1%


of the total.


In the six


to ten


year


category were


persons


or 12.1%


of the sample.


Those


employed


the lon


gest


eriods


of time


included:


for 11


to 15


years,


persons


or 5


for 16-35


years


persons


V) 70/ .~n. -t


a tnt art ~U- -~ ~-CI a-a.a. -f-a t ....52C--


n ~o! .I,


tl


e,,,


rn nn n











Special


Training


in Gerontology


Of those


subjects


who answered


this


item,


257 (63.9%)


indicated


they


had received


some


type of


special


training relating


to working with


older persons.


The remaining


persons


reported


no such


experiences.


In conjunction with


this


question


subject s


responding


in the affirm-


ative were


asked


to briefly


describe


their


special


training.


Many


these


responses


indicated


the training was


received


in the form of


workshops


they


attended


after


becoming


employed


in their present


positions.


Relatively


few subjects


reported


specific


education


training


Special


in gerontology prior


Training


to employment.


in Counseling


Subjects


were


also


asked


to indicate


their preparation


in the


field


training


of counseling.


in this


Of those


area.


responding,


The remainder,


206 or 55.8% noted


163 or 44.2%


some


, reported


preparation.


As in the item


related


to gerontological


training,


majority


of respondents


during and/or


because of


described


their


their


current


counseling

employment.


training

Again,


as occurring

few subjects


were


prepared


in counseling


prior


to becoming


employed


in their


present


positions.


Participants,


however,


indicate


more


training


gerontological


topics


then


they


claimed


in counseling


skills.


Data


for the demographic


information


portion


of the questionnaire


were


also


analyzed


cross


tabulations


of items.


Tabular


displays











Table


displays


the crosstabulation


of the sex and racial


group


characteristics of the sample.


Of the respondents,


or 25%


were


male


Caucasians


228 or


61.0%


were


female


Caucasians.


Fifty


persons


indicated


belonging


an ethnic minority,


comprising


13.4%


of the


sample.


Ethnic minority males


were


the least


represented,


providing


2.1%


or 8


persons


in the sample.


Female minority members


totalled


or 11.3%.


A crosstabulation


of sample


characteristics


classified


position


title,


sex,


race,


is displayed


in Table


The State


Program Office


for Aging


and Adult


Services


included


15 Caucasian males


and 17


Caucasian


females,


which


accounted


for 4.0%


4.6%


of the total


sample,


Caucasian


respectively.


males


District


and 20 Caucasian


Program


females,


Office


Staff


or 3.0%


included


and 5.4%


of the total


sample


occurring


in these


categories,


respectively.


Six ethnic


minority


females


and one minority male


were


employed


in the district


and state Aging and Adult


Services


Program Offices


combined.


Areawide


Agency


on Aging


staff


included


ten Caucasian males,


or 2.6%


of the sample,


and 33


Caucasian


females,


or 8.9%


of the sample.


There were


two ethnic


minority


females


sampled


from


this


subgroup.


ethnic minority


males


were


reported


in the Areawide


Agency


on Aging


sub-


sample.


Specialized Adult


Services


staff


included


one ethnic minority


male;


however,


there were


Caucasian


males,


Caucasian


females


1~ ~ ~ A. 1 .----7~- ~-- ...


and

9


ill -Lrt,


*


r






80



TABLE 6


CROSS


TABULATION


OF SAMPLE


CHARACTERISTICS


SEX BY RACE


Race


Total


Caucasian


Ethnic Minority


Male


25.5


Female


61.1


11.3


Total


86.6


13.4










TABLE


CROSSTABULATION


OF SAMPLE


POSITION TITLE


CHARACTERISTICS:


BY SEX AND


RACE


Position


Race


Caucasian


Ethnic Minority


Total


Male


Female


Male


Female


State


Offi


District
Staff

AAA Staff


Project


Program


11
3.0

10
2.6


Staff


20.2


SAS Staff


22.0

227


Total


25.5


61.0


11.3











Demographic


items


nine


and 11 related


to special


training


experience


in working with


older persons


or in counseling


were


crosstabulated


sex and


race.


As shown


in Table


Caucasian


males


reported


special


training


or experience


in working with


elderly,


37 subjects


in this


category


reported no


such


experience.


Minority


males


indicated


special


training


in four


cases


and four


others


in this


subgroup


reported


no special


training


or experience.


Caucasian


females were

ience, while


evenly divided; 14

79 others did not.


,7 reported


receiving


Twenty-eight


minori


training o

ty females


r exper-

indicated


training

Ta

experience


or experience; 14

ble 8 presents a

e and specialized


in this


similar b

training


group re

reakdown


sponded


negatively.


of the respondents'


in counseling.


Caucasian


reported


female


respondents


reported


affirmatively


in 118


cases;


subj ects


indicated


no such


backgrounds


ethnic minority


in either


females


report


training

ed traini


or experience. T

ng or experience;


wenty-seven

15 of the


subjects


reported


none.


Caucasian males


were


apparently


trained


experienced


in 58


cases


not so in 37


Minority


males


were


evenly


divided


on this


variable:


four


reported


no training or


experience


counseling


while


four


responded


positively.


Table


provides


a crosstabulation


of position


education


sex.


In the


extreme,


the State


Program


Office


group


contained


the only


two Ph.D.


staff


sampled,


while


there


were


persons


on the specialized


adult


services


staff,


one person


working


an aging


proj ect


--A -


A-- A. r 7 -1 1


1-- -I


- S


i.











TABLE


CROSSTABULATION OF
SPECIAL TRAINING OR
OLDER PERSONS AND


SAMPLE CHARACTERISTICS:
EXPERIENCE IN WORKING WITH
COUNSELING BY SEX AND RACE


Race


Caucasian


Ethnic


Minority


Total


Male


Female


Male


Female


Working with
Older Persons


58
15.6

37
10.0


147
39.6


Total


95
25.6


8
.9 2.2


42
11.3


Counseling


57
15.4


118
32.0


38
10.3


106
28.


15
4.1


Total


95
"Ct 7


224
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42
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04CN


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for 4.


of the sample.


The State


Program


Office


persons


with


Master


degrees


or 6.5%


of the total


sample.


A crosstabulation


of number


years


in present


position


race


is presented


in Table


Caucasian


females


included


the sample


had been


employed


for 26-35


years,


while


108 of this


category


had been


employed


for less


than


years.


Only


one ethnic minority


female


fell


in the 16-25


years


service


category,


while


17 of these


females


reported


that


they


had been


in their


present


positions


less


than


years.


Four


Caucasian males


were


in the 11-15


years


of service


category


and there


was one ethnic minority


male


with


to ten


years


tenure


in his present


position.


Of the Caucasian


males,


46 of the 95 reporting


on this


item


had been


employed


in their


present


positions


from


two to


five


years.


Further


analysis


of sample


characteristics


is shown


in Table


This


table


includes


a crosstabulation


of position


education


subject.


Of the 34 respondents


employed


in the State


Program


Office,


one individual


had a Master's


degree


in Gerontology.


None


among


those


sampled


in the District


Program Office


staff


reported


degrees


in the


field


of gerontology.


However,


five


Areawide


Agency


on Aging


staff


indicated


that


they


held Master'


degrees


in Gerontology.


remainder


of respondents


in this


category


included


one four year


degree


Master's


degree


among


project


staff,


one Master's


degree


among


the specialized


adult


services


staff.


To summarize.


there


were


nine


sex


one


I










TABLE


CROSSTABULATION OF SAMPLE CHARACTERISTICS:
NUMBER OF YEARS IN PRESENT POSITION BY SEX AND


RACE


Years


Race


Caucasian


Ethnic Minority


Total


Male


Female


Male


Female


Less


Than


30
8.1


108
29.0


2-5 Years


46
12.4


72
19.4


14
3.8


6-10


Years


11-15


Years


11
3.0


16-25


26-36


Over


Years


Years


36 Years


Total


95
25.5


227
61.0


42
11.3