The purpose of this research is to explore associations between the informal support network and the formal social support system as they converge in the delivery of outpatient services. It is proposed that in some cases the health care system may function as a source of social support to those with limited social and economic resources. To examine this proposition, the research plan focuses on those elderly who are most vulnerable because of their limited social and economic resources and those settings which have integrated comprehensive social services in the delivery of outpatient care. Our specific objectives are fourfold. 1) The research will assess the fit between the patients' needs and their social resources and will indentify the level of distress created with unmet needs. 2) We will examine associations between their informal supports and their utilization of health and social services. 3) The research will identify linkages between between the informal and formal network to establish those situations in which the formal system complements the informal system and those in which it substitutes or compensates for its deficiencies. 4) The research will also use ethnographic methods to explore the subjective costs and rewards obtained in the social support process. In this qualitative portion of the research, the objective is to identify those supportive dimensions of primary relationships which can be transferable to secondary relationships in the formal support system. To accomplish these objectives, a sample of outpatients, 65 years and older will be drawn from two outpatient clinics where pilot research has already been conducted. The population of elderly served in these clinics has high proportions who qualify for Medicaid and S.S.I. Many also have abbreviated social networks and high levels of functional impairment. Both clinics have integrated comprehensive social services into the delivery of health care. The project will use a combination of methods: review of medical records, focussed interviews, standard geriatric assessment instruments, and naturalistic observations in the clinics.
| Johnson, C L; Barer, B M (1990) Families and networks among older inner-city blacks. Gerontologist 30:726-33 |
