Social Work and a Relatives Support Group in a Psychogeriatric Day Hospital: A Research Note

Summary During the course of an evaluative study of a new psychogeriatricday hospital we encountered the fact that amongst the staffthere is very widespread support, in general terms, for theimportance of offering a service to the relatives of patients.A Relatives Group, in which the social worker attached to thehospital plays a leading role, is a major component of thisservice. However, the Group remains comparatively self-contained,is organised somewhat separately from the main body of hospitalactivities, and in practice systematic liaison with relativeshas not formed any major part in the planning and design ofthe organisation as a whole. Apart from the Relatives SupportGroup, there are only a small number of occasions on which relativeshave any regular contact with hospital staff. In this note we shall summarise our research which describesthe nature of social events which are encompassed within theGroup meetings. The research concludes that the Relatives SupportGroup sustains an ideology of service to relatives while confiningmany of the practical tasks so entailed to an organisationallocale which limits the degree of ‘relatives disturbance’to the rest of the institution. An implication of this thesisfor social work in medicine is that, in so far as social workersplay a significant part in running such groups, their attemptsto introduce relatives in this way as significant consumersmay, ironically, serve only to limit the impact of this groupwithin the system of medical care.     

Elderly African Americans as intragenerational caregivers

A growing number of older Americans serve as caregiving resources for their elderly spouses, partners, relatives, and/or friends. Yet, little research has addressed the impact and implications of this trend among African Americans. This article describes the results of a qualitative study examining the intragenerational caregiving experiences and perspectives of two cohorts of African Americans (urban and rural, N = 129) between the ages of 58 and 89. Its findings reveal important differences and commonalities associated with elderly African American caregivers and their care giving in urban and rural settings. Additionally, the study suggests that volunteer caregivers can often fill the void left by partners and relatives who predecease or fail to assume responsibility for the care of their elderly relatives. Their efforts do not displace those of friends and family members, but rather address unmet needs in available care. The discussion focuses on the implications of the study findings for public policy and practice.     

Family Caregivers of the Elderly

Two groups of primary family caregivers were interviewed; one whose older relatives received assistance from an inhome chore services program, the other whose relatives had been terminated from service due to budget reductions. Both groups of caregivers were found to be actively involved in providing care to their older relatives. The assistance that caregivers provided was similar whether or not their relative received chore services. No significant differences were found in the type of tasks they provided nor in the amount or length of time they have provided care. The data suggest that there may be limits to the assistance that these caregivers can provide and that care of the elderly beyond such limitations needs to be supplied by other sources. Caregiving may be influenced both by the particular circumstances of the caregiver and the individual needs of the older relative. These findings support the notion that there is a need for shared responsibility between the family and government, based on an understanding of the tasks that family caregivers are best able to provide.     

Attitudes of Medical School Workers Towards Reorganization

Summary This paper arises from a four-year project funded by the Departmentof Health and Social Security, concerning the social needs ofthe physically sick—a study of some aspects of the socialneeds of the physically sick and of the services designed tomeet needs. The present focus is on social work services andin this part of the project a development study has been undertakenand postal questionnaires have been sent (a) to all medicalsocial workers employed in the Hospital Service and in localauthority Health and Welfare Departments, and (b) to all otherhospital social workers engaged in helping the phsically sickand handicapped persons. In addition, a Survey is being carriedout through records of 9,000 admissions to a number of hospitalsto see how many of these patients are referred to the hospitalSocial Work Departments in a nine-month period, at what stagein their hospital careers they are referred, etc. A Survey is being carried out in four hospitals using a randomsample of patients and another sample referred for social workhelp. These patients are being interviewed in hospital and afterdischarge to see what kind of problems are encountered in hospitaland after discharge and what services are provided. Interviewswith medical, nursing, administrative and social work stabstractand included in this survey. The overall objectives of the Survey are to study needs andservices and to indicate how closely services respond to needs.     

Moving into Homelessness After Psychiatric Hospitalization

A six-month follow-up study of 132 former patients of a state hospital examines those subjects who become homeless and compares them with those subjects who do not. A quantitative and qualitative approach is used to document the process of homelessness that occurs after psychiatric hospitalization. A set of policy options is resented that can respond to the special needs of homeless mentally ill persons.     

Schizophrenia: The Impact of Parental Illness on Children

This research sets out to discover what impact parental schizophreniamakes on a child’s life. It focuses on the daily lifeand experiences of children. Their health, education, familyand leisure activities are examined. Contact with helping agenciesand their unmet needs are investigated. The sample was drawnfrom the children of patients attending the mental health servicesin South West Dublin. They were matched with a control groupof children of well parents. The majority of children who haveone parent with schizophrenia had similar profiles to the childrenof well parents in the areas of physical health, positive familyfeelings, friendships, hobbies and household tasks. In a numberof other areas, however, differences were found. Sample childrenhad more psychiatric disturbance, more problems associated withschool, less contact with relatives and spent more time at home.The children had little access to services and were upset byhospital visiting. The need for an educational programme andsupport for these children was demonstrated. It is recommendedthat a more co-ordinated approach is required by both adultand child mental health services in order to meet their needs.     

HEALTH NEEDS OF MIGRANT VIETNAMESE WOMEN IN SOUTH‐WEST BRISBANE: AN EXPLORATORY STUDY

This study was conducted in the southwest area of Brisbane, Australia, and is designed to explore and assess the health needs of Vietnamese migrant women. The needs of this group are becoming increasingly urgent due to ageing of the original immigrant refugee community and decreased capacity for support from their children and families. The study used a qualitative research strategy involving focus groups and in‐depth interviews with Vietnamese women between 18–65 years and interviews with Vietnamese health care providers. It shows that the women have had to deal with culture shock, low self‐esteem, lack of friends and relatives, unrecognized professional skills and most importantly in health terms, low socioeconomic status. Significant barriers to access health services and to improved health and well‐being were also identified, such as language difficulties, transportation, time, and knowledge about health education. Recognition of specific requirements of sub‐populations as well as broader socio‐economic and cultural determinants of health should be a guide to more effective planning and implementation of health promotion strategies. The changing needs, over time, of these sub‐populations should also be recognized.     

Charging and Quasi-Markets in Community Care: Implications for Elderly People with Dementia

Social services authorities in the UK are increasingly involved in charging and fee collection activities with clients in receipt of community care services. This article explores the implications of these developments for elderly people with dementia. The starting point of the article is a critique of existing legal and administrative options for handling other people's money, including the difficulties and dilemmas raised for both paid and unpaid carers by the existing arrangements. This is then related to the failure of charging and fee collection systems which have developed as a result of the community care reforms to address the particular needs of elderly people with dementia. A case study of policies in one local authority is outlined and this is followed by the presentation of the view of 37 fieldlevel professionals who were interviewed in focus groups. The concerns of these respondents included the complexity of the assessment task, conflicts between care managers and finance/revenue staff, the difficulty of defining and responding to financial abuse, and dilemmas over the extent to which relatives and carers should be trusted. The final section of the article considers the implications of a move to quasi-markets in social care for elderly people with dementia, particularly in terms of their vulnerability to financial exploitation.     

唐代省亲现象与省亲制度

唐代特殊社会群体的省亲现象,包括官员省亲、士子省亲、僧人省亲等。官员省亲是实现官员"忠孝两全"的道德理想和国家"以孝治国"的有效途径;科考赴举、落第、擢第省亲体现士子获得鼓励、安慰或扬名显亲的心理;僧人省亲现象在初盛唐具有争议到中晚唐为社会普遍接受。更具社会伦理意义的官员省亲受国家政治制度约束,包括省亲假及其时限、请假程序、省亲赏赐等。     

Kinship Foster Care and Its Impact on Grandmother Caregivers

Summary

Kinship foster care programs are designed to address the needs of relatives, usually grandparents, who have taken in children who have been removed from their homes voluntarily, or following a substantiated report of neglect and/or abuse. The author reviews the history of kinship foster care nationally and examines related research. Reported are findings on a survey of kinship foster care programs nationwide and from qualitative interviews with nine grandmothers from New York City who were kinship foster care providers. Particular attention was paid in these surveys to the impact of kinship foster care on families caring for children with disabilities.     

医药卫生体制机制创新：特殊矛盾和路径选择

在市场经济条件下,医药卫生事业发展面临五大特殊矛盾。我国医疗卫生事业要解决的首要问题是体制机制创新问题。公立医院改革和医疗保险体制改革相结合,建立以公益性医院为主体的医疗保险职能和公共医疗服务职能相结合的制度统一、全民覆盖、统筹城乡的新型公共医疗服务保险制度,构建政事分开、管办分开、医保基金管用分开的医疗卫生管理体制,化解现行医药卫生体制蕴藏的内在矛盾,是破解我国医改难题可行的路径选择。     

大学生职业决策心理的调查与分析

编制调查问卷采集抽样数据对大学生进行职业决策心理的调查与分析,结果显示:大学生的职业决策是综合因素考虑的结果,大学生择业时会对就业成本的生活需求进行分析,也会考虑就业单位的性质与地域意向,对职业工作与个性匹配充满期望,同时也会受到他人,特别是家人对职业抉择的影响。职业指导应注重多元化和全程化,促使大学生尽早做好职业规划,帮助大学生具备清晰的职业认知和明确的就业意向适应未来社会生活和发展的需要。     

The role of informal caregivers in the well‐being of orphans in Botswana: a literature review

With the orphan population escalating, communities continue to rely on relatives to provide care to orphans. Therefore, there is a need to explore the role of caregivers with regard to the well‐being of orphans, the challenges they face, as well as how they could be empowered to be more responsive to children's needs. The paper acknowledges that informal caregivers play an important role in the lives of orphans. The paper also concedes that, in the process, caregivers are faced with challenges which make it difficult for them to fulfil their responsibilities and roles. As a result, they sometimes act as sources of stress to orphans, which eventually complicate the children's adjustment to the loss of their parents. Lastly, the paper paves the way to ensuring that challenges faced by informal caregivers are addressed in a manner that will make them more supportive to orphans.     

Letters and Visits to Long-stay Broadmoor Patients

Summary Long-stay psychiatric patients are at risk of being institutionalisedand abandoned by their relatives. Special Hospital patientsare particularly vulnerable due to the compounded features ofmental disorder and criminality, together with the long termnature of their detention. A survey of 132 long-stay Broadmoor patients showed that a largenumber were neglected by their families but that many were sociallyisolated before admission. There was a significant differencebetween the amount of contact enjoyed by male and female patients.It is suggested that isolated patients should be identifiedand encouraged to take a more active interest in the outsideworld, and relatives given more encouragement to maintain theirinterest.     

Admission to Nursing Homes in Taiwan

The population of Taiwan is facing a radical ageing process. A proportion of the growing number of people aged 65 and over is expected to need nursing home care. This research concerns the family context of decision‐making in the process of admission to a nursing home in Taiwan. Employing survey data from interviews with elderly people in nursing homes (235 interviews) and their carers/key families (265 interviews), the factors affecting their views about admission were explored. Bivariate analysis and a logistic regression model were also used to examine perceptions of alternatives to nursing home care among family members with elderly relatives in nursing homes. Most elderly people in Taiwan are cared for in their own homes by their families but, in some circumstances, entry to a nursing home seemed inevitable. This research found that the decisions were taken mainly within a family context. The adult children of the elderly people, carers/key families’ preferences and the availability of carers influenced the decision. Apart from the important need factors of elders, families’ views about alternatives to nursing homes were significantly influenced by their preferences. This study has important implications for long‐term care in Taiwan. It is hoped that this will be needs‐led, both by elderly people and their families.     

Children with relatives abroad: assessment for placement

This study investigated a sample of children being considered for placement with relatives abroad where there were no relatives in the UK, or where the immediate family could no longer provide the care they needed. International Social Service is frequently asked to arrange for reports to be written on the suitability of relatives abroad to care for the child. The survey, based on questionnaires completed by local authority social workers, showed that following reports related to 108 sample children, 37% were placed abroad and 63% remained in the UK. Although the majority remained in the UK, the proportion of children placed abroad was higher than had been expected. The two most significant factors predicting placement were whether or not the relative abroad was offering to provide care and the impression of the relatives given by the report writer. Older children and black, Asian and mixed parentage children were more likely to remain in the UK. The paper ends with a discussion of these findings and implications for practice, policy and legislation.     

北京城市贫困家庭的社会支持网

本文在问卷抽样调查的基础上对北京城市贫困家庭社会支持网的规模、功能、关系构成及各类关系的支持作用进行了分析。研究发现,社会支持网的平均规模为2.21;社会支持网的功能以无偿经济援助和精神支持为主,在劳务支持方面有一定作用,但在为贫困家庭解决就业问题方面,作用十分有限;以近亲(父母、兄弟姐妹)为主的亲属是贫困家庭获取社会支持的最主要来源,其他亲戚在各种支持中的作用都很弱,而非亲属在就业支持方面有较大作用。     

Care of the Elderly—A Project,a Protest,a Survey and a Plan

Rehousing of elderly people in Australia has generally not been preceded by research into the kind of assistance that is necessary. An example is given of how an attempt was made to discover the needs of the elderly disabled in a small country community. Assessment by observation of people at home revealed the need for assistance for them to stay where they were. Home Care organized from the district hospital is often a more appropriate answer to this problem than the building of expensive and unnecessary institutions.     

Family Visiting with Institutionalized Mentally Impaired Aged

The nature and frequency of interaction between 43 mentally impaired aged residents in a long term care facility and their relatives was studied. It was found that in most cases the frequency of visiting remained stable over time, and in addition, the relatives combined visiting with other tasks-gift giving, assistance with grooming, etc.-on behalf of their family members. The artice includes recommendations for institutional staff help to these relatives as they cope with the continuing decline of the aged person.