Children's Appraisals of their Experiences in Out-of-Home Care

Few studies have asked children directly about their experiences in out-of-home care. This study uses data collected from 180 nine- to-11-year-old children currently in out-of-home care who were asked about their perceptions and appraisals of out-of-home care. Analysis of variance and chi-square analyses were used to examine whether children's appraisals of their lives following removal from their families of origin differ as a function of age, gender, race/ethnicity, type and severity of maltreatment, length of time in out-of-home care, placement type, attachment to current caregivers, and rating of current caregiver/home. Youth who were sexually and emotionally abused, youth who were satisfied with their current caregivers and placements, and girls were more likely to state that their lives would have been worse had they remained with their families of origin. Youth who were physically abused were more likely to report that their lives would have remained the same. Children living in group care were more likely than those living in family foster care or with kin to report that their lives would have been better had they remained with their families of origin. Differences were not found between children living in family foster care and those living with kin nor did children's appraisals differ based on age, race, ethnicity, length of time in out-of-home care, neglect, or severity of maltreatment.     

Post-adoption service need and access: Differences between international,kinship and non-kinship foster care

Post-adoption services are important to bolster a family's commitment to their adopted children, thus avoiding potential problems following adoption finalization. It is vitally important to assess post-adoption services in an effort to ensure families are provided with effective supports for successful family functioning. Few investigators have assessed service needs and access according to adoptive family type. This study focuses on international, foster care kin and foster care non-kin adoption types. Utilizing the National Survey of Adoptive Parents, this research investigated twelve post-adoption services. Two comparisons were made with respect to whether, according to the adoptive parents, post-adoption services were received or not received: 1) international and foster care non-kin adoptive families; and 2) foster care kin and foster non-kin adoptive families. International non-kin families were more likely to indicate they discussed post-adoption services than foster care non-kin families, particularly among those who were white, had adopted boys, had no other children in the home, and whose socio-economic background was lower. When comparing foster care non-kin families with kinship families, non-kin families tended to receive more desired services than kinship families, with kinship families indicating less need for services. Policy efforts and program design need to focus on reaching out to families and developing effective post-adoption services based on the expressed needs of families.     

Maternal foster families provide more stable placements than paternal families

The use of kinship families to provide foster care has been increasing due to changes in legislation and the hope that it will provide better quality placements, but there has been little consideration of differential outcomes based on sub-types of kin. Using data from one Ontario, Canada, child protection agency we compared the frequency and stability of placements with maternal versus paternal kin. We found that maternal relatives provided placements much more often than paternal kin and this was most striking with single grandmothers. 90% of genetically related kinship caregivers were grandparents or other equally close kin. Maternal and paternal kin placements had similar durations, but maternal placements ended significantly more frequently by the child returning home or obtaining a permanent placement, whereas paternal placements more often broke down. A Cox proportional hazards analysis, controlling for child sex, age, reason for placement and caregiver attributes, showed that paternal kin placements were more than twice as likely to break down as maternal kin placements, within a given interval. We discuss whether placement stability should be considered a proxy for placement quality and policy implications, and we comment on aspects of assessing prospective placements.     

Kin and non-kin foster care—findings from a National Survey

This article uses national data to look at the differences between children in kinship and non-kinship care arrangements. Three groups are compared: children in non-kin foster care, children in kinship foster care, and children in “voluntary” kinship care. Children in voluntary kinship care have come to the attention of child welfare services, are placed with kin, but unlike those in kinship foster care, these children are not in state custody. Findings suggest that children in the kin arrangements faced greater hardships than those in non-kin care. They more often lived in poor families and experienced food insecurity. They were more likely to live with a non-married caregiver who was not working and did not have a high school degree. And fewer kin than expected received services to overcome these hardships. In addition, nearly 300,000 children lived in voluntary kinship care arrangements; these children are of particular concern because they are not in state custody and therefore may or may not be monitored by a child welfare agency.     

Foster parent and teacher assessments of youth in kinship and non-kinship foster care placements: are behaviors perceived differently across settings?

With a growing number of children living in kinship foster care, it is important to understand how youths are faring in kinship care compared to youths in non-kinship care. In the present study, we first evaluate teacher ratings of problem behaviors exhibited in school by youths in kinship and non-kinship foster care. We then examine whether correspondences between parent and teacher ratings of problem behaviors across home and school settings differ by kinship status. The youths in the study represent an ethnically diverse sample (N = 185), with significantly more children of color in kinship placements. Across the majority of problem behavior scales on the Teacher's Report Form (TRF: Achenbach, 1991), teacher perceptions of youth behavior did not differ significantly according to kinship or non-kinship care placement. Furthermore, the youths in this study had elevated scores relative to general population norms on only a few TRF problem behavior scales. A sub-sample (N = 122) with foster parent assessments on the Child Behavior Checklist (CBCL: Achenbach, 1991) permitted comparison of perceptions of youth behavior across the home and school settings for youths in kinship and non-kinship placements. Correlations between the TRF and CBCL composite scale scores (internalizing, externalizing, and total problem behaviors) indicated slightly higher agreement between teacher and foster parent ratings for kinship placements. The non-kinship foster parents reported higher levels of problem behavior at home relative to school. The paper interprets these results and suggests implications for practice and future research directions.     

A survey of Colorado's migrant farmworkers: access to health care

This report utilizes data collected in a 1986 sample survey of 329 adult (18 to 50 years old) migrant farmworkers in Colorado to determine their health needs, health services utilization, and overall access to care. Health needs include selected indices of medical, dental, nutrition, and reproductive health. About 1/4 of the population had no usual source of health care. Upstream states such as Colorado are responsible as the primary providers of health services for those who either have no source of health care at their home base or experience a variety of barriers in their attempts to access services. Women are most likely to have had a medical visit over the past 12 months and are more likely to have experienced hospitalization. Unfortunately, although their contact with medical professionals is more frequent, the family planning needs of women are not being met. A large disparity exists between ideal family size and number of pregnancies and live births. The findings of this survey document the inferior health status of the migrant farmworker population in Colorado. Hunger, poverty, and environmental hazards increase the risk of illness, while at the same time, barriers to care often prevent migrants from accessing needed health services. Recommendations include 1) promoting and funding family planning and reproductive health services for migrant farmworker women and their partners, 2) incorporating trained family planning promoters in the migrant health delivery system, 3) maintaining successful models of restorative dental care for adults, 4) increasing access to services in nontraditional settings, 5) increasing use of ancillary personnel to provide services, especially dental services, 6) maintaining outreach programs in the available food programs, and 7) encouraging migrant health programs to provide leadership in the development of alternative food sources.     

Geographic distance and intergenerational relationships in Chinese migrant families

ABSTRACT

This study examines the effect of adult Chinese migrants’ geographic distance from home on their intergenerational relationships with parents who remain behind. We compared monetary and family care support as well as emotional relationships among four parent-child groups: older adults and international migrant children, older adults and internal migrant children (who migrated to other cities in China), older adults and coresiding children, and older adults and local children (living in the same city as their parents). Data were derived from 332 older adults in Beijing, China, with at least one child who migrated to another country or city. Results from chi-square tests, anaylsis of variance (ANOVA) tests, and regression analyses indicate that international and internal migrant children maintain similar intergenerational relationships with their parents, and that both of those groups are less likely than coresiding and local children to have family care exchanges and emotionally close relationships with their parents. The results may help professionals develop supportive services and policies for older adults in migrant families.     

In the Best Interest of the (Adult) Child: Ideas About Kinship Care of Older Adults

This article uses a qualitative, ethnographic approach to examine the experiences of older adults and their kin, as the older adult engages in relocation. Studies looking at caregiving by kin for older adults highlight burdens for the adult child. This study offers a life course perspective on kinship care, analyzing older adults’ decisions to move. It was found that many older adults are strongly influenced by the desire to not be solely cared for by their kin, as well as to select housing near their existing social network, which might exclude kin. In conclusion, policy implications are discussed.     

Coresidence and Geographic Proximity of Mothers and Adult Children in Stepfamilies

Children who live with or near a parent provide more care and receive more help from parents than geographically distant children. Stepfamily ties may be weaker than ties between biological kin, but little is known about the geographic proximity of step‐ versus biological kin. The authors used data from the Health and Retirement Study (N = 13,239 mothers and 45,675 biological and stepchildren) to show that stepchildren and stepmothers are less likely to live together, less likely to live nearby, and less likely to move closer than biological children and mothers. When mothers have only stepchildren, they are less likely to have a coresident child or a child nearby than mothers with both step‐ and biological children. Coresidence and geographic proximity are lower in stepfamilies formed after divorce than after widowhood. The findings are consistent with a legacy of conflict and strain and the likely competing needs of biological and stepmothers.     

Independent living programs: Do they make a difference?

Children are entering foster care at an alarming rate. There were an estimated 429,000 children in out-of-home care at the end of 1991, which is a 64% increases since 1982 (Tatara, 1990). The largest proportion of children in out-of-home care are between the ages of 13 and 18 (Mech, 1988; Tatara, 1989). Each year, an estimated 16,000 (Sims, 1988) to 18,000 (Ryan, McFadden, Rice, & Warren, 1988) youth are emancipated and leave foster care to assume independence. Many of these young adults are not prepared for self-sufficiency (Barth, 1986, 1990; Festinger, 1983; Westat, 1988). Adolescents from varying out-of-home care settings are eligible for a set of services—Independent Living Programs.The findings of this study suggest that Independent Living Programs may have positive impact on the ability of youth to be self-sufficient at the time of discharge from foster care programs. The youth who participated in the ILP program were more likely to complete high school, have employment history and employment at discharge, and were more likely to be self supporting at the closing of the case.and Ms. Scannapieco is a research assistant, Temple University Center for Human Development and Education.     

Transition from Home Care to Nursing Home: Unmet Needs in a Home- and Community-Based Program for Older Adults

A major effort is under way nationally to shift long-term care services from institutional to home- and community-based settings. This article employs quantitative and qualitative methods to identify unmet needs of consumers who transition from a statewide home- and community-based service program for older adults to long-term nursing home residence. Administrative data, care manager notes, and focus group discussions identified program service gaps that inadequately accommodated acute health problems, mental health issues, and stressed family caregivers; additional unmet needs highlighted an inadequate workforce, transportation barriers, and limited supportive housing options. National and state-level policy implications are considered.     

Transition from home care to nursing home: unmet needs in a home- and community-based program for older adults

A major effort is under way nationally to shift long-term care services from institutional to home- and community-based settings. This article employs quantitative and qualitative methods to identify unmet needs of consumers who transition from a statewide home- and community-based service program for older adults to long-term nursing home residence. Administrative data, care manager notes, and focus group discussions identified program service gaps that inadequately accommodated acute health problems, mental health issues, and stressed family caregivers; additional unmet needs highlighted an inadequate workforce, transportation barriers, and limited supportive housing options. National and state-level policy implications are considered.     

Caregiving and Care Receiving Among Older Lesbian,Gay, and Bisexual Adults

Abstract

A survey research design was used to examine caregiving, care receiving, and the willingness to provide caregiving among lesbian, gay, and bisexual (LGB) older adults recruited from community groups. More than one-third reported receiving care from people other than healthcare providers in the last five years; more than two thirds provided care to other LGB adults. Those who had given care were more likely than non-caregivers to give care in the future. The gender and sexual orientation of recipients of future help affected participants' willingness to provide care, as did their education level and style of coping. Participants willing to provide care to older LGB adults perceived such experiences to be less burdensome and more personally rewarding than those who were un-willing to provide care.     

The relationship of placement experience to school absenteeism and changing schools in young,school-aged children in foster care

Background

Chronic school absenteeism and frequent school changes, particularly among younger children, may be antecedents for the high rates of school failure and subsequent dropout among youth in foster care. However, the relationship of foster care experience to absenteeism and school change has not been well studied.

Objective

This study examined the association of placement experience with absenteeism and changing schools among 209 urban children in foster care enrolled in public elementary schools.

Methods

A cohort of children aged 5 to 8 years who entered non-relative or kinship foster care from 2006–2008 were followed longitudinally for 2 years from entry into foster care. Children residing in foster care were categorized at the end of the study as early stable, late stable, or unstable, if they achieved a permanent placement prior to 45 days, between 45 days and 9 months, or failed to do so within 9 months, respectively. Children who reunified home were classified as a fourth category. Poisson regression, controlling for baseline factors, was used to compare days absent and number of schools attended across categories of placement experience.

Results

Among the 209 children, 51% were male, 79% were African American, and 55% were initially placed with kin. One third of children reunified home; among children who did not reunify, one half was early stable, and a third was unstable. Adjusted rates of school absenteeism increased in stepwise fashion as children's placements became more unstable; children with unstable placements were 37% more likely to be absent than those with early placement stability (p = 0.029). Children who reunified during the study demonstrated the highest rates of absenteeism; however, there was no significant difference in absenteeism before or after reunification. Number of schools attended increased as stability worsened, with the standardized rate of schools attended reaching 3.6 schools (95% CI 3.1–4.1) over a two year period among children in unstable placements.

Conclusions

The relationship between placement experience and school absenteeism and school change illustrates the need to better coordinate the educational experience of high-risk children in foster care. The secondary finding of high absenteeism among children in the process of returning home illustrates that educational challenges for youth may be equally if not more concerning among the greater majority of youth in child welfare who remain home with birth parents.     

Experiences of Informal Caregivers of Older Adults Transitioned From Nursing Homes to the Community Through the Money Follows the Person Demonstration

This study examined experiences of 156 informal caregivers of older adults who transitioned to the community through the Connecticut Money Follows the Person (MFP) Rebalancing Demonstration after prolonged nursing home stays. Caregiver burden, positive aspects of caregiving, depressive symptoms, anxiety, and comparative subjective stress were examined in relation to caregiver demographics and care receiver characteristics with a cross-sectional survey. Caregivers reported low burden, depressive symptoms, and anxiety, and fairly high levels of positive aspects of caregiving and satisfaction with community services. Most caregivers were less stressed compared to the time the care recipient was in, or before they entered, a nursing home. Live-in caregivers experienced more positive aspects of caregiving, but adult children reported higher burden than other caregivers. Unmet service needs also increased caregiver burden. Programs like MFP are a viable option with broadly positive outcomes from a caregiver’s perspective. Enthusiasm for increasing access to community care is growing for older adults who otherwise would reside in nursing homes for extended periods. Identifying unmet service needs and needs for targeted functional support could further enhance caregiver experiences and contribute to the successful transition of older adults to the community.     

Adolescents in foster care: Predicting behavioral maladjustment

This exploratory study utilized foster caretakers as the source of information about foster care adolescents' behaviors. Foster care maladjustment was operationalized as the incidence of internal and external maladaptive behaviors reported by the youths' caretakers. Child-related variables and organization-related variables were then used to predict foster care maladjustment. The sample consisted of 152 randomly selected adolescents 16 years old and older in foster care under the supervision of the Los Angeles County Department of Children's Services. White youths and those in group homes/residential settings were more likely to have dysfunction in both areas. In addition, those youths placed at older ages and those who had spent more time in their current placement were more likely to exhibit external maladaptive behaviors. Treatment and service delivery implications are drawn from these findings. The importance of the foster caretaker as a provider of information and as a participant in the treatment process is also highlighted.     

‘Generation boomerang’ in Germany? Returning to the parental home in young adulthood

Leaving the parental home is not always a one-off event in the course of a person's life. Young adults can return one or more times before leaving home permanently. The aim of this article is to analyse the social and economic transition markers and socio-demographic factors which play a role in the return to the parental home of young adults in Germany. The analysis is based on the survey AID:A, conducted by the German Youth Institute in 2009. Data from 4300 young adults, aged 18–32 years, who left the parental home at least once, are used. Young adults are differentiated by their current residential status: living with at least one parent again (returners) or living outside the parental home (leavers). The results show that, the more financially and socially independent a young person is, the less likely they are to return to the family of origin. Furthermore, growing up in a two-parent family in West Germany as well as a strong relationship between fathers and sons increases the likelihood of returning to the parental home after leaving. Notably, it was also found that young adults of Turkish and Eastern European origin are more likely to return than those of German origin.     

The Best Laid Plans: Expectations,Preferences, and Stability of Child‐Care Arrangements

This study considers whether an earlier and more extensive search for child care, and a match of the type used to the type preferred, predicts arrangement stability. We used the National Institute of Child Health and Human Development Study of Early Child Care to estimate multinomial logit models of arrangement changes over 3‐month intervals between 3 and 12 months (n= 958 children and 2,223 observations). Use of preferred care predicted greater arrangement stability, and parents who settled early on 1 option were less likely later to switch care types. Those who planned earlier were more likely to use their preferred care type and to use higher quality settings. This study encourages future research on how, when, and with what success parents search for child care.     

Kinship care of the abused child: the New Zealand experience.

The concept of continuity--keeping children within their own kinship, community, and cultural networks--has found international favor in contemporary child welfare practice. This principle is reflected in the 1989 New Zealand Children, Young Persons, and Their Families Act. The Act represents a significant shift--from the state to the family--in responsibility for children in need of care. The increasing use of the Family Group Conference process allows families to make decisions about the future of kin children and reflects the belief that, although most abuse is intrafamilial, the family will also be the most committed to keeping the child safe. Other countries have adapted this model to suit their own cultural child welfare needs. The international trend toward formal use of kinship care for children who have suffered abuse or neglect is likely to continue as foster care resources shrink. Drawing on qualitative research, this article describes the experiences of caregivers and their kin children who have been the subject of a care and protection order.     

Medicaid Managed Care Programs for High-Risk Older People in Massachusetts

The Commonwealth of Massachusetts has undertaken a major initiative in the development of comprehensive managed health care programs for two sets of high-risk older people: those who are frail and homebound and those who reside in nursing homes. This effort has been coordinated by the state's Department of Public Welfare (DPW; Medical Assistance [Medicaid] Program) and Executive Office of Elder Affairs, and expedited ba a set of Health Care Financy Administration (HCFA) waivers and by the state's revised Nurse Practice Act (MGS Chapter 56). Than act allows nurse-practioners and physician assistants expanded roles as primary providers in home care and nursing home settings. The managed care initiatives have supplemented other efforts (1) to coordinate health and social services for older people, (2) to provide as broad a range as possible of community-based services for older people, and (3) to enroll as many older adults as possible in Health Maintenance Organization (HMO) "Senior Plans" and other similar "Competive Medical Plans."

Though there is still no evidence of the managed care programs' effects, this article summarizes some of the possible risks and benefits of managed care programs for those kinds of populations and presents an agenda of questions that evaluations of managed care programs must address.