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===Technology in Nursing Homes=== | ===Technology in Nursing Homes=== | ||
- | [[Image:Wii_old_folks2.jpg|frame|left| | + | [[Image:Wii_old_folks2.jpg|frame|left|Senior citizen playing Wii <ref>http://blog.motionfitness.com/?p=932</ref> ]] |
Nursing homes are embracing technology. Care networks are being used in nursing homes, which involve nurses and residents wearing a device that interacts with sensors throughout the facility. The system alerts nurses if someone falls or if an at risk resident is trying to get out of bed. The system also records information about how promptly the nurses respond and how long they spend with the resident, ensuring a higher quality of care.<ref name="cheek" /> Better care is also being provided with touch screens beside the residents’ beds allowing them to order food, request medication, open the window, or adjust the temperature.<ref name="cheek" /> Computer games are also being used to provide recreation for the elderly and can help show declines in things like perceptual problems, deficits due to strokes, and other physical problems.<ref name="ogo" /> Nursing homes are even using Wiis to promote balance in their at risk population. The physical demands of the game allow the residents to improve their balance and other motor functions.<ref>Clark, R., & Kraemer, T. (2009). Clinical use of nintendo wii(TM) bowling simulation to decrease fall risk in an elderly resident of a nursing home: A case report. ''Journal of Geriatric Physical Therapy, 32''(4), 174-174-80. </ref> The only way that technology can be effective in assisting the baby boomers as they age is for it to be accessible.<ref name="ogo" /> Nursing homes have made progress regarding this issue, but hopefully as the baby boomers enter their care, technology will be incorporated even further into daily life. | Nursing homes are embracing technology. Care networks are being used in nursing homes, which involve nurses and residents wearing a device that interacts with sensors throughout the facility. The system alerts nurses if someone falls or if an at risk resident is trying to get out of bed. The system also records information about how promptly the nurses respond and how long they spend with the resident, ensuring a higher quality of care.<ref name="cheek" /> Better care is also being provided with touch screens beside the residents’ beds allowing them to order food, request medication, open the window, or adjust the temperature.<ref name="cheek" /> Computer games are also being used to provide recreation for the elderly and can help show declines in things like perceptual problems, deficits due to strokes, and other physical problems.<ref name="ogo" /> Nursing homes are even using Wiis to promote balance in their at risk population. The physical demands of the game allow the residents to improve their balance and other motor functions.<ref>Clark, R., & Kraemer, T. (2009). Clinical use of nintendo wii(TM) bowling simulation to decrease fall risk in an elderly resident of a nursing home: A case report. ''Journal of Geriatric Physical Therapy, 32''(4), 174-174-80. </ref> The only way that technology can be effective in assisting the baby boomers as they age is for it to be accessible.<ref name="ogo" /> Nursing homes have made progress regarding this issue, but hopefully as the baby boomers enter their care, technology will be incorporated even further into daily life. | ||
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==The Baby Boomers and Drugs and Alcohol== | ==The Baby Boomers and Drugs and Alcohol== |
Revision as of 20:39, 27 November 2011
Contents |
Aging Baby Boomers - Changing the Definition of Old Age
The baby boomers are categorized as the group of individuals born between 1946-1965.[1] Post world war II, the birth rates sky rocketed; the baby boomers were the result of the greatest population increase in Canadian demographic history [2] .
During this time period there were three major movements that helped shape this cohort: technological advancement[3], increased drug and alcohol use[4] , and the sexual revolution [5] . Due to these three movements the baby boomers are very different than the previous generations. Because the boomers have different attitudes, beliefs, and behaviours they pushed boundaries regarding many controversial issues, which have shaped the world as we know it today.
The baby boomers are healthier [6], demanding [7], wealthier, and better educated [1] than previous generations. This year the first baby boomers turn 65, and for the next 20 years it is predicted that this large group will take their attitudes and behaviours with them into late adulthood (18). Since, these boomers have such different attitudes from previous generations of senior citizens, they will create shifts in the perceptions about what it means to be elderly; boomers do not fit previous stereotypes about senior citizens [3].
Retaining independence is particularly important to this generation [7]. However, it is inevitable that with the large number of individuals within this cohort that some of the boomers will end up in long-term care facilities. Not only are the boomers bringing their changed behaviours and attitudes into late adulthood, they will also bring these shifts into long-term care facilities. As a result, long-term care facilities will have to adapt.
The Baby Boomers and Technology
Simply put, the aging baby boomers will mean an increase demand for healthcare and long term care facilities.[6] The current systems does not have the resources to compensate for the added strain that the baby boomers will put on the system, so other solutions are needed. One possible solution is technology. Previous generations of senior citizens have been afraid of and opposed to technology [3]; however, the boomers are characterized as a very different generation [1] and most importantly, do not fit previous stereotypes about senior citizens and technology.[3] The baby boomers were the first generation to be brought up with televisions and other profound technological advances. [3] Furthermore, the baby boomers are not anxious about using technology and have experience with it that allows them to feel at ease. [3] Technology will be integrated in two settings as the baby boomers age, at home and in nursing homes.
Technology at Home
The baby boomers want to remain in their own homes, doing the same activities that they have been doing all of their lives. [1] With the shortage of long term housing and the financial burden the boomers will place on the healthcare system, society haa to make aging in place a reality.[8] Aging in place means remaining where an individual has lived, with the use of technology to assist them as their health conditions change.[8] Technology that permits seniors to remain in their homes allows them to feel empowered, capable, involved in their own health care, and engaged in the world around them.[8] Technology use leads to fewer hospital visits and shorter stays at hospitals and nursing homes [6], benefiting not only the seniors but also the healthcare system.
Smart Homes
Smart homes are automated environments that uses technology to facilitate comfort and independence.[9] Smart homes can include an announcement system that informs the elderly individual of the day, time, appointments, and daily tasks.[8] Sensors can also be used throughout the home to turn on lights or detect motion outside of the home.[8] Seniors can also wear special shirts that monitor vital signs or pacemaker function, which allows physicians to monitor the individual from afar.[8] Pendants and bracelets that when activated connect the individual to 24 hour assistance provide the elderly emergency assistance when needed and peace of mind.[8] Home designers are beginning to build homes with smart technology built in, in hopes of facilitating aging in place.[8]
Medication Systems
![Pill Pet](/common/Image/a/a0/Pillpets.jpg)
A common problem for seniors is remembering to take their pills at the right time and in the right amount. Technologists have created automated dispensers that dispense only the proper amount, dispensers with locks for people with dementia, and virtual pets that prompt seniors to take their pills.[7] These virtual pets get sick if their owners fail to follow their medication regime, inducing an emotional response from the senior.[7] Talking glucose monitors have also been developed to help seniors with visual impairments make sure that they are managing their blood sugar appropriately.[8]
Computers
Computers are allowing seniors to do their shopping and banking from home [9], which helps them cope with mobility issues. The baby boomers are a well educated generation, [1] and computers offer an avenue for continued education in a flexible and individuated manner.[6] Seniors also often feel isolated in their homes and the internet has provided a solution for this. There are now multiple senior networks that allow seniors to interact through emails, blogs, and forums.[8] The internet has made it possible for seniors living at home to continue to interact with the outside world.
Technology in Nursing Homes
![Senior citizen playing Wii](/common/Image/c/cc/Wii_old_folks2.jpg)
Nursing homes are embracing technology. Care networks are being used in nursing homes, which involve nurses and residents wearing a device that interacts with sensors throughout the facility. The system alerts nurses if someone falls or if an at risk resident is trying to get out of bed. The system also records information about how promptly the nurses respond and how long they spend with the resident, ensuring a higher quality of care.[8] Better care is also being provided with touch screens beside the residents’ beds allowing them to order food, request medication, open the window, or adjust the temperature.[8] Computer games are also being used to provide recreation for the elderly and can help show declines in things like perceptual problems, deficits due to strokes, and other physical problems.[9] Nursing homes are even using Wiis to promote balance in their at risk population. The physical demands of the game allow the residents to improve their balance and other motor functions.[12] The only way that technology can be effective in assisting the baby boomers as they age is for it to be accessible.[9] Nursing homes have made progress regarding this issue, but hopefully as the baby boomers enter their care, technology will be incorporated even further into daily life. --Lw09pz 13:15, 27 November 2011 (EST)
The Baby Boomers and Drugs and Alcohol
The baby boomers grew up during a time of social revolution when it came to drugs and alcohol. The boomers grew up in a time when there was free experimentation with drugs, including marijuana, cocaine, LSD, and heroine. The boomers also grew up in an era with many medical drug advances, such as anti biotics, a new and ‘quick fix’ to any health problem[13]. Medication was made more readily available and was encouraged in order to maintain a healthy lifestyle. With all of the drug experimentation and increased use of drugs for medical purposes it is no wonder that the baby boomers are more likely to abuse illicit drugs, alcohol, and over the counter drugs [14]. It is because of the aging boomers, that substance and alcohol abuse in the elderly is becoming a mounting concern for society, the healthcare system, treatment centres, and long term care facilities.
Substance Abuse
The definition of substance abuse is not universally agreed upon[15]. Furthermore, the criteria often used to diagnose substance abuse are often hard to apply to the elderly or hard to untangle from general age related declines [16]. A common criterion is giving up social activities and failure to fulfil a social role [16]. Elderly people may not fall under these standards since most elderly people are retired and do not work or do not go to school. They also generally live at home and their social interactions become reduced as they age. Elderly people are also less likely to admit, or believe they have a problem because of the embarrassment and shame that it would cause them [17] .Due to the comorbidity of drug and alcohol abuse problems with other health risks and the compromised health status of many elderly individuals, it is essential for physicians, family members, and other health care providers to recognize abuse problems in the elderly [4] the number of geriatric alcohol-related disorders are expected to rise as this cohort ages.
Prescription and Over the Counter Drugs
Individuals aged 65 and older consume more over the counter drugs than any other age group[16]. Furthermore it has been stated that baby boomers are dependent on medication and will continue to be even into old age, as the number of prescriptions for the elderly increased 154% from 1992 to 2002[13]. Currently the elderly population is about 13% of the total population, but they account for 30% of prescription drugs and 40% of over-the-counter drugs sold[16]. Since the baby boomers are going to drastically increase the percentage of elderly population, it is safe to say that the number of prescription and over-the-counter drug use will also increase over the next few decades.
Illicit Drugs
The baby boomers are more likely than earlier generations to abuse illicit drugs and to have added health and financial problems associated with the complications from the use of illicit drugs [14]. Research has indicated that generations with histories of illicit drug use in their youth are more likely to have increased rates of illicit drug use as they age[14]. Since the baby boomers grew up in an era when drug use was at its peak [4], they are more likely to continue to use these drugs well into old age. Historically it was believed that there were low rates of illicit drug use during old age, with the notion that drug users died early or their habit phased out [14]. . However, more recent data suggest that older adults develop adaptive skills that allow their drug use to continue and that with advanced technology and medicine, people lie longer with a better quality of life, allowing for dependency to last into late adulthood[14].
Treatment
The article by Gfoerer, Penne, Pemberton & Folsom (2003)[4] suggests that by 2020 the amount of elder adults with substance problems will increase dramatically because of the baby-boom cohort. This will require a change in the current treatment plans. Most treatment plans are geared toward younger age groups and centre on illegal drug use[17]. The need for proper diagnosis techniques is a must in the upcoming years, along with tools that are reliable to screen the elderly population. The education of doctors in spotting and diagnosing substance problems will be important in lowering cases and help people with their addiction sooner[17].
Alcohol, Drugs, and Nursing Homes
When not living in nursing homes elderly individuals have the choice of whether or not to consume alcohol, smoke, or do drugs; however, when living in a nursing home decisions about these types of activities are most often made by staff [18]. Nursing homes must balance the rights of the resident with the health risks associated with these activities [18] and since these activities are commonly associated with negative health risks they are often strictly controlled by nursing homes. Some nursing homes serve alcohol at social events, some allow private possession of alcohol, some require that the nursing staff retain possession, and others require a doctors order for the consumption of alcohol or use of drugs [19]. As the baby boomers continue to age nursing homes will have to re-evaluate their drug and alcohol policies in order to both satisfy the desires of this generation and to protect their safety.
Baby-Boomers and the Sexual Revolution
![Gay, lesbian, bisexual, and transgendered individuals walk the streets on Christopher Street Day in 1970, a day celebrating their freedom of sexual expression](/common/Image/9/90/Gay.jpg)
Human sexuality is the opportunity to experience an emotional closeness with another [21] . The baby-boomers grew up during the sexual revolution, a time that promoted freedom of sexual expression and exploration. Contraceptives were released in the early 1960’s which increased the number of couples practicing premarital sex, and the expansion of pornography cinemas and PlayBoy clubs in the late 1960’s made sex publically available[5]. As well, the Gay Rights Movement that started in 1970 was a huge sexual revolution for gay, bisexual, and transgender (LGBT) communities, giving them freedom to practice their sexual orientation openly[22].
Prior to the aging Baby-Boomers, there has been little importance placed on sexuality in old age[2]. The stereotype genuinely held is that elderly couples lose their sexual drive and are too frail to participate in sexual intercourse [2]. There is no doubt that research confirms that there is a decline in sexual activity in late adulthood[2] . However, this is usually due to a lack of partner in late adulthood or poor health. A more common cause of decreased sexual activity in the elderly population is from the lack of privacy or basic sexuality training that care providers receive in nursing homes [23].
However, with the advancements in technology such as dating sites and medical drugs to treat climacteric syndromes, we can expect older adults to be sexually active much longer than previous generations. These aging adults are more comfortable, open, and embrace their sexuality. Within this large cohort, many of these Baby-Boomers will end up in long-term care facilities. With the Baby-Boomers bringing their sexual habits and behaviours into late adulthood, long-term care facilities for the elderly will have to accommodate to their needs.
The Sexual Behaviors Baby-Boomers Bring into Old Age
Single-Hood & Dating
One of the main reasons why sexual behavior decreases is often due to a lack of partner in later adulthood. With over half of all marriages ending in divorce before a couple’s 30th anniversary [24], more adults find themselves single in later adulthood with dating as a reasonable option.
The side link is a video clip from Dr. Laura Berman who talks about the sexual behaviours of the Baby-Boomer Generation: Lust or Bust? Inside the Baby-Boomer Bedroom[26]
Risky behavior regarding dating is also a concern for this elder population. In a study by News Week Magazine, single Baby-Boomers reported more likely to engage in unprotected sex after a first date in fear of thinking their sexual prime was over. Therefore, they were more likely to take the chance if the opportunity presented itself [27]. Another reason being post-menopause, there is no longer the risk of getting pregnant [28] . The Public Agency of Canada reported a rise in number of sexually transmitted diseases (STD) found in the elderly population over the last few years, with only 50% of these elder sexually-active singletons worried about contracting an STD [28] .
Same-Sex Couples
Same-Sex couples have become more prominent in society in the last few decades [29]. The Gay Rights Movement gave homosexual Baby Boomers a sense of pride instead of embarrassment about their sexual orientation, which encouraged them to come out sooner than previous generations [30] . Starting in the late 1960s, pride parades have been held annually to celebrate LGBT individuals freedom of sexual expression[22] .
Pharmaceutical & Technology Advances
Sexual behaviours are becoming prolonged into late adulthood due to pharmaceutical and technology advancements. About one third of the internet is used for sexual related websites [31], and with the expansion of the internet in the last few decades, the elder population is finding dating sites and online sex chat rooms a useful option [32] . With this increasing demand, websites have been created to target single seniors (SeniorNet.com, 4Seniors.com, ThirdAge.com, etc.) [33]. Sexual habits are also being prolonged into later adulthood due to sexual enhancing drugs that have been developed to treat things like erectile dysfunction disorder [34]. This has expanded the sexual window for older adults.
Elder Sexuality in Long-Term Care Facilities
There seems to be varying views among care providers regarding the importance of sexual behaviour in older adulthood [32]. Care providers with little experience working in nursing homes express more negative views, viewing sexuality in older age as disturbing, and therefore making it their job to intervene any sort of intimacy. Many of these nursing homes implement open door policies, and are found to have more single rather than double beds [32].
However, with the Baby-Boomers bringing their attitudes from the sexual liberation along with them, the views regarding sexuality in older adulthood are changing [32]. A more positive view is becoming more common throughout long-term care facilities. More recently, it is being recognized that older people have sexual needs, and it is an essential component to maintaining one’s mental and physical health [32]. Nursing homes with a more positive view have staff undergo sexuality training, and have rules in place protecting the privacy of residents. These include providing residents with a “do not disturb” sign they can hang on their door, staff members are required to knock before entering the residents’ rooms, or even giving residents privacy to phone call girls [32]. Since sexual activities may also impose safety concerns, such as contracting an STD [31], some care facilities hold sexual health seminars and provide counseling to educate residents on safe sex practices and issues[21].
In 2010, a survey was conducted in the United States to uncover the sex lives of elderly in institutionalized care. Over three quarters of residences from age 57-64, over half of 65-74 year olds, and a third of those 75-85 years old remained sexually active (ranging from intercourse, oral sex, masturbation, etc.)[35]. Even though this number decreased with age, it shows sexuality is still a priority in later adulthood but often remains over looked.
Elder Same-Sex Couples Within Long-Term Care Facilities
With the legalization of same sex marriage in 2005 [37], same-sex couples are becoming more common in nursing home environments. Long-term care providers will have to be sensitive to their resident’s sexual orientation [30] . Still, many care facilities are not homosexual friendly, portraying images of heterosexual couples on pamphlets, or heterosexual terminology (i.e. asking male elders about their wife when they are gay) used by staff with the assumption that residents are straight [38] . Most nursing home social service directors lack training in working with lesbian, gay, and bisexual residents. Only 24% of care providers report receiving any homophobia training in their workplace [38] . Lack of knowledge and training on such an issue has resulted in 81% of LGBT couples being reluctant to reside in nursing homes[39]. Many face isolation in a nursing home centre, and are more likely to develop depression or commit suicide [29] . Recently, many urban areas are developing LGBT Aging projects with the purpose of educating care facilities on how to better integrate the needs of the LGBT elder community members [29] .Notes and References
- ↑ 1.0 1.1 1.2 1.3 1.4 Steel, D. M., & Gray, M. A. (2009). Baby boomers' use and perception of recommended assistive technology: A systematic review. Disability and Rehabilitation,4(3), 129-136. doi: 10.1080/17483100902767175
- ↑ 2.0 2.1 2.2 2.3 Bjorklund, B. R., Bee, H. L. (2008). The journey of adulthood (6th ed.). New Jersey: Pearson Education, Inc.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Niemela-Nyrhinen, J. (2007). Baby boom consumers and technology:shooting down stereotypes. Journal of Consumer Marketing, 24(5), 305-312. doi: 10.1108/07363760710773120
- ↑ 4.0 4.1 4.2 4.3 Gfroerer, J., Penne, M., Pemberton, M., Folsom, R. (2003). Substance abuse treatment need among older adults in 2020: the impact of the aging baby-boom cohort. Drug and Alcohol Dependence, 69, 127-135.
- ↑ 5.0 5.1 Escoffier, J., & McDarrah, F.W. (2003). Sexual revolution. New York: Thunder’s Mouth Press.
- ↑ 6.0 6.1 6.2 6.3 Soar, J. (2010). The potential of information and communication technologies to support ageing and independent living. Anals of Telecommunications, 65, 479-483. doi: 10.1007/s12243-010-0167-1
- ↑ 7.0 7.1 7.2 7.3 MacMillan, D. (2006). A new breed of tech for the aging. BusinessWeek Online, 6. Retrieved from EBSCOhost.
- ↑ 8.00 8.01 8.02 8.03 8.04 8.05 8.06 8.07 8.08 8.09 8.10 8.11 Cheek, P., Nikpour, L., & Nowlin, H. D. (2005). Aging well with smart technology. Nursing Administration Quarterly, 29(4), 329-338.
- ↑ 9.0 9.1 9.2 9.3 Ogozalek, V. Z. (1991). The social impacts of computing: Computer technology and the graying of America. Social Science Computer Review, 9, 655-666. doi: 10.1177/089443939100900409
- ↑ http://rememberitnow.com/blog/2010/05/17/medication-reminders-tech-savvy-top-5/
- ↑ http://blog.motionfitness.com/?p=932
- ↑ Clark, R., & Kraemer, T. (2009). Clinical use of nintendo wii(TM) bowling simulation to decrease fall risk in an elderly resident of a nursing home: A case report. Journal of Geriatric Physical Therapy, 32(4), 174-174-80.
- ↑ 13.0 13.1 Dowling, G. J., Weiss, S. R. B., Condon, T. P. (2007). Drugs of abuse and the aging brain. Neuropsychopharmacology, 33(2), 1-10.
- ↑ 14.0 14.1 14.2 14.3 14.4 Lay, K., King, L. J., & Rangel, J. (2008). Changing characteristics of drug use between two older adult cohorts: Small sample speculations on baby boomer trends to come. Journal of Social Work Practice in the Addictions, 8(1), 116-126.
- ↑ Boeri, M. W. (2002). Hell I’m and addict, but I ain’t no junkie: An ethnographic analysis of aging heroin users. Human Organization, 63(2), 236-245.
- ↑ 16.0 16.1 16.2 16.3 Menninger, J. A. (2002). Assessment and treatment of alcoholism and substance-related disorders in the elderly. Bulletin of the Menninger Clinic, 66(2), 166-183.
- ↑ 17.0 17.1 17.2 Beynon, C. (2011). Diagnosing the use of illegal drugs by older people – comments on the proposed changes to dsm-v. Addiction, 106(5), 884-885. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.03283.x/pdf
- ↑ 18.0 18.1 Stefanacci, R. G., Lester, P. E., Kohen, I., & Feuerman, M. (2009). Nursing home policies on items brought in from the outside for facility residents. American Medical Directors Association, 10(6), 419-422.
- ↑ Carol, J. (2011). One last pleasure? Alcohol use among elderly people in nursing home. Retrieved from http://www.allbusiness.com/human_resources/3589283-1.html
- ↑ Skipper, R. (2011). Celebrating pride week: Broadway sings for pride, Jacqueline Jonee, Terri White. Retrieved from http://richardskipper.blogspot.com/2011/06/celebrating-pride-week-broadway-sings.html
- ↑ 21.0 21.1 Pangman, V.C, & Seguire, M. (2000). Sexuality and the chronically ill older adult: A social justice issue. Sexuality and Disability, 18, 49-59.
- ↑ 22.0 22.1 Head, T. (2011). The American gay rights movement: A short history. Retrieved from http://civilliberty.about.com/od/gendersexuality/tp/History-Gay-Rights-Movement.htm
- ↑ Gott, M., & Hinchliff, S. (2003) How important is sex in later life? The views of older people. Social Science & Medicine, 56, 1617–1628.
- ↑ Ottawa Divorce. (2007). Canadian divorce statistics. Retrieved from http://www.ottawadivorce.com/statistics.htm
- ↑ Pandey, B. (2009). Restore your sex drive and spice it up in old age. Retrieved from www.babapandey.com/…/2009/12/Old-people-3.jpg
- ↑ Berman, L. (2008). Lust or bust? Inside the baby boomer bedroom [Video File]. NBC News The Today Show: Retrieved from http://today.msnbc.msn.com/id/23340559/ns/today-relationships/t/lust-or-bust-inside-baby-boomer-bedroom/
- ↑ Senior Journal. (2006). Boomers Changing How Older People View Sex, Romance, says Newsweek. Retrieved from http://seniorjournal.com/NEWS/Boomers/6-02-13-BoomersChanging.htm
- ↑ 28.0 28.1 Vogel, L. (2010). Canadian baby boomers shirk safe sex. The Canadian Mental Association: 182(18), 827-828. Retrieved from http://www.cmaj.ca/content/182/18/E827.full
- ↑ 29.0 29.1 29.2 Gross, J. (2007). Aging and gay, and facing prejudice in twilight. The New York Times. Retrieved from http://www.nytimes.com/2007/10/09/us/09aged.html?pagewanted=all
- ↑ 30.0 30.1 Hughes, M. (2004). Privacy, Sexual Identity and aged care. Australian Journal of Social Issues, 39 (4), 381-392.
- ↑ Cooper, A. (1998). Sexuality and the Internet: surfing into the new millennium. Cyberpsychology and Behavior, 1, 181–187.
- ↑ 32.0 32.1 32.2 32.3 32.4 32.5 Shuttleworth, R., Russell, C., Weerakoon, P., & Dune, T. (2010). Sexuality in residential aged care: Residential aged care: A survey of perceptions and policies in australian nursing homes. Sexual Disability, 28, 187–194
- ↑ Strombeck, R. (2003). Finding sex partners on-line: A new high-risk practice among older adults. Journal of Acquired Immune Deficiency Syndromes, 33, 226–228.
- ↑ Lindau S.T.,& Gavrilova, N. (2010) Sex, health, and years of sexually active life gained due to good health: Evidence from two US population based cross sectional surveys of ageing. British Medical Journal, 340, 810.
- ↑ Lindau, S., Schumm, L., Laumann, E., Levinson, W., O’Muircheartaigh, C., & Waite, L. (2007). Study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357, 762–774.
- ↑ Howley, N. (2010, March 8). Sonoma county, CA agrees to $60k settlement for splitting up elderly gay couple. Injury Lawyers News: Retrived from http://nicolehowley.visionsmartnews.com/sonoma-county-ca-agrees-to-60k-settlement-for-splitting-up-elderly-gay-couple_1708.html
- ↑ CBC News. (2005). Same Sex Rights: The supreme court and same-sex marriage. Retrieved from http://www.cbc.ca/news/background/samesexrights/
- ↑ 38.0 38.1 Bell, S.A, Bern-Klug, M., Kramer, K.W.O, & Saunders, J.B. (2010). Most nursing home social service directors lack training in working with lesbian, gay, and bisexual residents. Social Work in Health Care, 49(9), 814-831.
- ↑ McFarland, P., & Sanders, S. (2003). A pilot study about the needs of older gays and lesbians: What social workers need to know. Journal of Gerontological Social Work, 40(3), 67–80.