Cash versus Child Care Services in Finland

In 1985 the Finnish Parliament passed a law which stipulated that all children under age three were to be guaranteed a day care place as from the beginning of the 1990s. The law was made possible by a political compromise in which the agrarian Centre Party won the backing it needed to push through a system of state subsidies for the home care of children. As an alternative to a day care place, parents were now given the option of taking a child home care allowance and using that allowance either for purposes of looking after their child themselves or for paying for a private place. Measured in terms of the number of users, the child home care allowance was a hugely successful innovation. Most parents of small children have used the allowance for at least some period of time. This was due above all to the size of the allowance compared with other social benefits. However, following cutbacks in allowance expenditure of more than 20 per cent from 1995, the use of home care allowances declined at almost the same rate as the allowances were reduced. This brought significant short-term savings to the Government and to local authorities, but in the longer term other costs have been rising. There has even been a sharp, unexpected decline in the birth rate. The case of Finland goes to show that, even in a country where wage-earning motherhood has become firmly established, income transfers through family policy can have a very significant influence on the numbers opting temporarily for homemaking.     

Gender Identity and Social Services: Barriers to Care

ABSTRACT

Transgender people seek social services for a variety of reasons. This literature review highlights needs assessments and social science research articles (N = 30) from the last 16 years that demonstrate the many ways in which social services are further revictimizing transgender people. Studies indicate that transgender people often encounter ignorance, hostility, and transphobic environments while attempting to access social services, and these environments can dissuade transgender people from gaining needed care. Suggestions are made to address these inequalities and include simple measures that social service agencies can begin with to make their services more transinclusive. Future research should address the bias in social services more directly and also develop a clear plan of action and best practices to help agencies remove discrimination from social service settings.     

Chapter 12. Trends and Developments in Home Care Services

No abstract available for this article.     

Choice,Competition and Care – Developments in English Social Care and the Impacts on Providers and Older Users of Home Care Services

This article critically examines recent changes in markets for home (domiciliary) care services in England. During the 1990s, the introduction of competition between private (for‐profit and charitable) organizations and local authority providers of long‐term care services aimed to create a ‘mixed economy’ of supply. More recently, care markets have undergone further reforms through the introduction of direct payments and personal budgets. Underpinned by discourses of user choice, these mechanisms aim to offer older people increased control over the public resources for their care, thereby introducing further competitive pressures within local care markets. The article presents early evidence of these changes on:

• The commissioning and contracting of home care services by local authorities and individual older people.
• The experiences and outcomes for individual older people using home care services.

Drawing on evidence from two recent empirical studies, the article describes how the new emphasis on choice and competition is being operationalized within six local care markets. There are suggestions of small increases in user agency and in opportunities for older people to receive more personalized home care, in which the quality of care‐giving relationships can also be optimized. However, the article also presents early evidence of increases in risk and costs associated with the expansion of competition and choice, both for organizations providing home care services and for individual older service users.     

Occupational Stress in Social Services: a Comparison of Social Workers and Home Help Staff

Correspondence to Jennifer Bradley, School of Health Sciences, University College Salford, Frederick Road, Salford M6 6PU. Summary An investigation of occupational stress among professional andsupport staff within a social services department in north-westEngland was carried out, with the aim of optimizing the useof resources in the planning of stress management interventions.A two-phased research design was used to collect qualitative(by interview) and quantitative data (by questionnaire). Theresults reported here are based on data from 63 social workersand 74 home helps, who were involved in ‘front-line’work with clients. Sources of stress, measures of individualwell-being, job satisfaction, rganizational commitment and absenteeismdata are described. Comparisons with other occupational groupsare included.     

Home Care Services for Indigenous Population in Taiwan: Cultural and Socio-Structural Implications for Long-Term Care Policy

Taiwan faces the world’s top aging rate over the next 8 years, making long-term care a priority for all populations, including the 16 indigenous groups who live primarily in the mountains and have different cultural practices than mainstream Taiwanese people. To examine how home care services are coordinated, managed, and delivered to the indigenous populations, we interviewed 10 public care managers and analyzed the interview content to assess their work experiences with home care workers and indigenous users in 2016. The research revealed four findings: (1) Home care utilization patterns and attitudes were different between the rural indigenous and non-indigenous populations; (2) home care utilization was limited by cultural, economic, and language challenges; (3) home care workers faced cultural and socio-structural challenges; and (4) policy and service provisions were rigid, without the socio-structural flexibility needed to accommodate the indigenous culture. A more efficient model will require the collaboration of public care managers, home care workers, and indigenous families to create a fair-coordinated plan. As Taiwan launches the Ten-year Long-Term Care Plan 2.0, a one-stop service delivery center to integrate care options and provide services for people of indigenous backgrounds is a must.     

Nursing Home Social Services Directors and Elder Abuse Staff Training

In a nationally representative study of 1,071 nursing home social services directors 80% of social services departments provided resident rights training and 60–70% were involved in abuse training. Departments headed by recent grads and in chain nursing homes or in the northeast were more likely to be involved in training. Seventy-two percent of social services directors were able to provide one-on-one training about reporting suspected abuse; education and licensure were related to ability to train.     

Promoting Personalization in Social Care Services for Older People

This article presents findings on 4 themes associated with the personalization of social care for older people: integration of health and social care services; initiatives that prevent the need for more costly interventions; services to maintain people at home; and systems that promote choice, control, and flexibility. The quantitative study utilized data from a national postal survey conducted in England. Findings suggest variable progress regarding the range and style of support available to older people. These are discussed in the context of service integration, community-based services, and consumer-directed care. Implications for service development and future research are highlighted.     

Nurse/Social Worker Role Conflict in Home Health Care

No abstract available for this article.     

Transformation of Social Care Services for the Elderly in Slovakia

ABSTRACT

The main objective of this article is to present a theoretical framework for the relevant historical, economic, demographic, and political factors influencing the transformation of social care services for the elderly in Slovakia. A major restructuring of the social care services for the elderly is necessitated by the aging of the Slovak population (demographic reason), the path dependency of the current Slovak elderly care system (historical reason), the growing purchasing power of older people and the general population (economic reason), and new requirements formulated by the European Union and the general public (political reason). Historical documents, legislative acts, strategic documents, international project documents, and statistics were reviewed, and 34 open-ended interviews within the framework of two case studies were carried out in order to obtain qualitative and quantitative data. The theoretical framework and the results based on those interviews indicate that the Slovak social care service for the elderly may turn out to become more similar to the advanced Central European systems, but also that prompt legislative and financial changes are required. Nevertheless, the future direction can only be more precisely identified when more case studies can be compared with one another.     

Nursing Home Social Services Directors Who Report Thriving at Work

Nationally representative data from a sample (n?=?928) of full-time nursing home social services directors were used to investigate whether knowing characteristics of the social environment at work can help to explain which directors report job thriving. Two-thirds of directors reported they were thriving in their jobs. Multiple regression results show that thriving is increased by job autonomy, being treated like an important part of the team, having enough time to identify and meet resident psychosocial needs, not having to do things that others could do, and being clear what the social services role is. Findings suggest that addressing these aspects of the social environment and social services role will likely contribute to increasing a sense of thriving at work among social services staff members.     

A New Look at Home Care and the Hospital Social Worker

Clinical, administrative and social action reasons for expanding social work services in hospital based home care programs are persuasive. Hospital departments of social work should consider carefully how they may expand services in home care and coordinate and integrate such activities with social work and discharge planning processes occurring throughout the hospital. It is necessary for social work leadership to be present on professional advisory, quality assurance and similar committees and to use these committees as arenas for expanding the social work role in home care.     

The Role of the Nursing Home Social Worker in Terminal Care

This study examines the role of the nursing home social worker in terminal care. Questionnaires were distributed to 60 social workers in 14 nursing homes in the greater Milwaukee area. The hypothesis was that the presence of policies/procedures governing terminal care would be related to a decreased amount of stress for social workers. This correlation was not supported by the survey results. Although 71% of respondents indicated no policies were available to them, only 32.6% of social workers reported that terminal care was a source of stress. In fact, 59% reported that the social worker's role in terminal care had not been discussed in the social services department of their facility. Comparative lack of stress for social workers may be related to the lack of perception that social workers play a significant role in the terminal care of residents.     

Inter-agency Information Sharing in Health and Social Care Services: The Role of Professional Culture

This article uses a literature review to examine the ways inwhich professional culture might shape inter-organizationalexchange of personal information in a health and social carecontext. The aim is to explore a simplified model of possibleinformation-sharing behaviours (‘ideal’, ‘over-open’,‘over-cautious’ and ‘chaotic’) and tosuggest that patterns of information sharing may be influencedby a number of factors. It is proposed that these factors includenot only inter-professional differences in the approach takento information sharing but also the ways in which the professionsinterrelate.     

构建社会工作视角下的居家养老服务模式

居家养老模式正在全国全面展开,但其服务专业化水平低,多数从业人员未掌握为老年人服务的价值伦理和专业方法,制约了居家养老模式的全面推进,影响了老年人的生活质量。引入专业社会工作,能够提升居家养老服务的专业化水平,提高居家养老服务的质量,促进居家养老模式的不断完善,解决我国人口老龄化难题。秉持并践行社会工作价值伦理,掌握并运用社会工作专业方法,能够提升居家养老服务的专业化水平。     

Autonomy,Choice and Control for Older Users of Home Care Services: Current Developments in Swedish Eldercare

In Sweden, a policy shift towards more individualized eldercare, with an emphasis on consumer choice, has taken place. The aim of this study was to analyze the processes and practices of individualized eldercare, focusing on preconditions for older peoples’ choice and control. Data consist of qualitative interviews with users of home care services (n – 12) and staff (n – 12) and participant observations (n – 7) of meetings between staff and older people. The choice and control available to older users emerged as decisions about ‘what’ care and services, ‘who’ should provide the care and services, and ‘how’ the care and services should be performed. Three approaches to enable older people choice and control over their home care services were revealed: test and revise, services elaborated in close collaboration between users, care managers and home care staff; choices in the moment, users could choose services at each occasion; and quality improvement through competition, competing providers develop attractive services. The findings could guide policy makers in combining the strengths of these approaches to enable older people in need of support to become co-producers in designing, managing, as well as consuming, care and services. Future quantitative research is needed to achieve generalizable knowledge about the strengths and weaknesses of different ways to organize eldercare services.     

A Study of a Total Social Services Care Population and its Inter-Agency Shared Care Populations

There are very few large population studies and little informationabout the characteristics of social services populations andthe inter-agency populations that social services departmentsshare with other agencies. This study fills this gap. It examinesa total social services adult care population, excluding residentialcare homes (N = 19,461) in the context of its general co-terminoushealth authority population (N = 646,239). Approximately two-thirds(61 per cent) of the social services population were women,compared to the health authority population of 51 per cent.Sixty-two per cent were over sixty-five years compared to 23per cent of the health authority. Age groupings and genderedpatterns of service use are then identified for different caregroups. The study then examines care populations shared betweensocial services and other agencies, identifying the amount ofshared care and the characteristics of specific shared caresubgroups. Forty-two per cent of the social services populationwere shared with the community health trust and 19 per centwith the mental health trust. The proportion of the social servicespopulation in contact with Criminal Justice and accident andemergency was nearly twice that in the overall health authoritypopulation. The limitations of these data are examined and thepotential of this method to inform inter-agency planning andshared care is discussed.     

Solving Problems in Foster Care: Key Issues for Young People, Foster Carers and Social Services

Philippa Padbury with Nick Frost The Children's Society, London, 2002, 116 pp. £12.95. ISBN 1 899783 44 X     

Integrating Mental Health Parity for Homebound Older Adults Under the Medicare Home Health Care Benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.