ELDERLY RURAL AFRICAN-AMERICAN WOMEN ALONE: STRATEGIES, CHOICES AND FRAILTY.

Description

The purpose of this qualitative study was to explore and describe aging, frailty, decision-making and help-seeking, and survival strategies used by frail, rural, elderly African-American women. The frailty trajectory served as the organizing framework. Tape-recorded directed conversations, informal conversations, and participant observation were the primary sources of data. An inductive analytical approach was used to identify patterns. Using purposive sampling the respondents included 41 panel members and 9 key informants. All were African Americans who lived in rural areas of North Central Florida. The key informants, selected from the panel, were women over 65 (mean age of 84), frail, and lived alone. Two types of aging were identified. "Up-in-years-old" indicated the accumulation of years of life without any implication of impairment. "Wore-out-old" indicated impairment but was not limited to those with advanced chronology. Frail was defined as ill, again regardless of years of life. Decision-making related to help-seeking reflected a paradigm of conservation of scarce resources. Help-seeking was most often covert or "asking-without-asking." Help-giving was most appropriately provided spontaneously and in a manner that can be described as "doing-without-asking." The needs of elders were expected to be observed and responded to by children and others. Help-receiving was dependent on the resources of the immediate family, concurrent familial obligations, and how "good" a person one was judged to be by those around him or her. All forms of helping were considered a spiritual blessing. The key informants depended on faith, minimized their needs and did without, and used limited resources creatively and carefully to survive living alone. Of these, the use of faith was the most important strategy. Informal support was facilitated by the close geographic arrangements of the residences of relatives. Other than home-delivered meals, formal support services were not used extensively. Recommendations for practice include suggestions of how and when to provide assistance to rural, elderly, African-American women who live alone. The need for culturally sensitive assessments and interventions is reinforced.

Subjects