Mental Health Needs and Supportive Services for Elderly and Disabled Residents

Abstract

This study longitudinally assesses the impact that the provision of supportive services has on the mental well-being of the elderly and disabled population living in independent housing developments. The results indicate that the use of supportive services by the mentally ill allowed them to overcome initial lower functional status and achieve a level of mental functioning virtually similar to that of the total resident population. Thus, it is argued that independent living facilities with supportive services can certainly be a successful and cost effective model for a number of frail elderly and mentally ill residents.     

城市社区居家养老服务的发展思路与对策

随着老龄化时代的到来,需要照料的失能、半失能、失独老人总量不断增加,在当前传统家庭的养老功能不断弱化、机构养老服务能力滞后的形势下,居家养老服务模式成为解决养老问题的重大战略抉择。但目前居家养老服务总体而言尚处于起步和试点示范阶段,在居家养老服务资源凝聚、开拓,居家养老服务运作和软硬环境营造等方面,面临不少问题和困境,建议从资金、人力、设施、运作环境等方面来解决居家养老服务的发展问题。     

Meeting the Unique Needs of Grandparent-Headed Families Using a Community-University Interdisciplinary Model

An interdisciplinary initiative engaging graduate students and faculty from education, social work, and physics was developed to address the unique needs of grandparent-headed families. The goal of this qualitative study was to deepen the current knowledge base about the challenges and benefits of using an interdisciplinary, collaborative community-university model to meet the unique needs of grandparent-headed families. Findings are discussed in terms of literature relevant to advancing grandparent-headed families’ educational progress and health with an emphasis on the interprofessional collaborative process.     

A Cost Comparison of Congregate Housing and Long Term Care Facilities for Elderly Residents with Comparable Support Needs in 1985 and 1990

No abstract available for this article.     

Using Video Clips as Test Questions: The Development and Use of a Multimedia Exam

SUMMARY

Innovations in multimedia provide new formats for delivering and scoring tests and for constructing test items. This article presents a case study of the development of a multimedia exam that assesses child protective services supervisor competence. It describes the need, design, development, validity, standardization, use, status, issues, problems, and lessons learned. While multimedia offers potentials, it also makes modifications, enhancements, and delivery more complicated. By examining this experience, others can avoid mistakes and pitfalls when undertaking future multimedia assessment endeavors.     

An Assessment,Using the Multiphasic Environmental Assessment Procedure (MEAP), of a Rural Life-Care Residential Center for the Elderly

This study reports the findings of an assessment of a life-care center for elderly persons in a rural area using the Multiphasic Environmental Assessment Procedure (Moos and Lemke, 1979a). The study assesses the physical and architectural features, the social climate, and the policies and programs of the home. The results are compared to previous assessments of sheltered-care facilities, and the findings of the study support similar research conducted by Moos and Lemke. The facility's selection process leads to a population with similar characteristics, tending to promote a harmonious environment. The residents have a positive perception of their personal environment which encompasses the physical and social environment and organizational structure. This type of environment offers a smooth transition from living in a private residence to a residential life-care center.     

A National Survey of Child Advocacy Center Directors Regarding Knowledge of Assessment,Treatment Referral,and Training Needs in Physical and Sexual Abuse

Mental health services are a core component of child advocacy centers in the United States. Child advocacy center directors were surveyed about (a) trauma and posttraumatic stress disorder; (b) referral criteria for treatment of abuse victims; (c) evidence-based treatments for abused children; (d) reliable, valid, and normed measures helpful in assessment; and (e) training needs. Directors accurately identified posttraumatic stress disorder symptoms, but additional symptoms were misidentified. Directors identified best practices for assessment and treatment, but they misidentified non-evidence-based practices. Primary reasons for referral for services included severity of abuse and emotional response of the child. However, referrals based on assessment findings were not a high priority. Directors expressed some training needs for staff consistent with issues identified in the study.     

Application of the International classification of functioning,disability and health in Taiwan: victory of the medical model

Since July 2012, eligibility for disability benefits and services in Taiwan has been assessed based on the International Classification of Functioning, Disability and Health. This study examines disabled people’s experiences of this new assessment system: does it incorporate the social model or a multidimensional understanding of disability and assess the needs of disabled people adequately? In-depth interviews were employed with 24 disabled persons to answer these questions from the perspective of disabled people. The findings show that the new assessment model is still medicalised: social roles and social participation are not considered, the assessment process is dominated by professionals, users’ perspectives are not included and only those who are assessed to have a high level of disability are satisfied with the new system while many others would prefer the old assessment system. These findings have relevance for the analysis of needs assessments of disabled people in different countries.     

Self-reported health problems,health care utilisation and unmet health care needs of elderly men and women in an urban municipality and a rural area of Bhaktapur District of Nepal

The study aimed to identify the felt common health problems, utilisation of health services and unmet needs of urban and rural elderly people of Bhaktapur district, Nepal. It was a cross sectional population study of people aged 60 years or more where 204 respondents were interviewed in 2009. The common felt problems were pain and swelling of joints (65.7%), indigestion (63.7%), excessive tiredness (38.2%) and hypertension (35.8%). Pain and swelling of joints (72.5%) and back pain (40.4%) were higher in rural elderly population whereas indigestion (67.6%) and hypertension (37.85%) were higher in urban population. Pain and swelling of joints (66.7%) and indigestion (69.6%) were higher in males, and hypertension (50.0%), back pain (38.2%) and chronic bronchitis/asthma (39.2%) were higher in females. The unmet needs varied between different health problems. In general women had more unmet needs than men, where 80 unmet needs were identified for the 102 men compared with 105 for the 102 women, and these unmet needs increased dramatically with age. This approach yields new insights into the health care needs of the elderly and will be helpful to health care planners.     

Participatory shaping of community futures in e‐waste processing hubs: Complexity,conflict and stewarded convergence in a Palestinian context

This article describes an unconventional participatory development approach carried out in an informal e‐waste hub in South‐West Hebron, an area that has collected and processed the bulk of Israeli e‐waste for over a decade. Our approach contributes to the critique and recovery of community representation in participatory development and the search for ways to facilitate representative community engagement. Specifically, we describe our use of a novel Delphi‐like method that allowed us to facilitate a broadly endorsed development trajectory within a heterogeneous and conflicted community. We show how the results yielded by this approach diverged from those that were likely to emerge from more facile forms of participation in ways that are important for other similar e‐waste hubs internationally, which face a destructive status quo on the one hand, or the economically ruinous international policies that ban e‐waste trade from “developed” to “developing” countries on the other. Despite real tensions and cleavages within the affected communities, the process described facilitated a shift from deadlocked environmental versus livelihood positions towards building capacity and regulating existing informal e‐waste trades to preserve livelihoods dependent on these.     

An Examination of the Adult Day Services Industry Using the Resource Dependence Model within a Values Context

The adult day services (ADS) industry continues to grow and develop in providing care to larger numbers of older adults and their caregivers. Despite the growth in the number of programs and the changes in the way services are delivered, a systematic examination of the development of the ADS industry from a policy perspective has not been published since the mid-1990s. This article provides an analysis of the development of the ADS industry using the resource dependence model within a values-based context to determine whether public reimbursement opportunities are congruent with the needs of older adults and caregivers. Potential directions for the future development of the industry are presented through analysis of the collaborations of adult day providers with the providers of other services for older adults and the effort by public and private funders to connect quality outcomes and resources.     

A Preliminary Qualitative Analysis on the Feasibility of Using Gaming Technology in Caregiver Assessment

This exploratory qualitative study examined the feasibility of utilizing gaming technology that will ultimately assess task performance and stress among caregivers of dementia patients. The long-term goal is to use this unobtrusive application (app) to detect caregiver burnout for the purposes of early intervention. This preliminary study examined participant interface with a specific gaming technology called CAST (Caregiver Assessment Using Serious Gaming Technology). Ten dementia caregivers participated. Participants attended a demonstration and then interacted with a preliminary version of the CAST tablet application. Social work researchers interviewed participants using open-ended questions to gauge interest, technology skill level, and comfort with the app. Participants expressed interest and identified potential ways to further develop the system in order to increase ease of use, decrease time commitment, and improve suitability for daily use. The provided feedback will be used to refine the user interface of the application, which will then be used to monitor caregivers’ stress in future development.     

The independent effects of socio-demographic and programmatic factors on economic strain among parents in a Child Savings Accounts program

This study examines the independent effects of socio-demographic variables and program social services on the degree of economic strain among lower income parents who had an opportunity to open child savings in a subsidized savings accounts program known as Saving for Education, Entrepreneurship, and Downpayment (SEED). SEED is a policy, practice and research initiative designed to test the efficacy of and inform policy for a national system of asset-building accounts for children and youth. Findings suggest that overall, the degree of economic strain was not significantly different at baseline and at the second wave between parents who opened accounts and those who did not open accounts for their children. However, household income, having a household savings account, and receipt of means-tested welfare programs affected the degrees of economic strain. Implications are directed toward helping lower income families effectively participate in child savings programs.     

Using the Community Assessment for Public Health Emergency Response (CASPER) to assess barriers to healthy eating and active living in a low-income community

Insufficient physical activity and unhealthy eating behaviors are major contributors to the obesity epidemic in the United States. Identifying health behaviors and disparities in underserved communities is needed to guide the development of targeted interventions. The Community Assessment for Public Health Emergency Response (CASPER) is a set of tools designed for public health emergencies, but the utility of CASPER in non-emergency settings has not been explored. The purpose of this study was to use CASPER to obtain information on household-based behaviors of and barriers to fruit/vegetable consumption and physical activity, and explore the utility of these methods for future health assessments. Cross-sectional survey data included households (n = 100) in a low-income neighborhood. Half of adults did not meet recommendations for fruit/vegetable consumption and 20% reported no physical activity during the previous week. Cost was significantly associated with healthy eating and physical activity in our community. Four primary advantages of using CASPER methodology included a user-friendly CDC toolkit, yield of a representative community sample with a relatively low sample size, low-cost/low-tech requirements for implementation, and the strengthening of an academic-practice-community partnership. Our work demonstrates the utility of CASPER for assessing healthy living in a geographically-defined community where household health behaviors and barriers are unknown.     

Involving Service Users in a Problem Based Model of Teaching and Learning

Since the introduction of the new degree in social work in the UK, programmes have been developing ways to involve service users, using differing models. This paper will explore how service users can enhance the inquiry based model of teaching and learning while at the same time emphasising the belief that process and content in teaching and learning cannot be separated. It will also show how this approach, by involving service users as consultants, creates expertise and can provide a ‘legitimate constituency’ and thus allow for meaningful participation of service users at all levels of social work education.     

Social and Health Service Use and Treatment Outcomes for Sexual Minorities in a National Sample of Substance Abuse Treatment Programs

This study examines substance use severity, levels of social and health service utilization, and the impact of service utilization on treatment outcomes for sexual minorities versus non-minorities. The sample included 3,094 clients from the National Treatment Improvement Evaluation Study (NTIES). Substance use severity among sexual minorities and non-sexual minorities was similar at treatment entry and at 12 months post-discharge. Differences in social and health service utilization were significant for substance abuse counseling and health services. Significant interactions between sexuality and access services and sexuality and mental health services were also found. Practice and research implications are discussed.     

Predicting Problem Gambling in Australian Adults Using a Multifaceted Model of Impulsivity

Impulsivity is a factor that has been linked strongly to problem gambling; however, conceptualization problems have impeded research in this area. Research suggests that there may be as many as five impulsivity subtypes and that some but not all of these subtypes are involved in problem gambling. This cross-sectional and correlational study used the multifaceted UPPS-P Impulsive Behaviour Scale as a predictor of problem gambling in a community (N = 200) sample of Australian adult gamblers. Of the five impulsivity subtypes, negative urgency, positive urgency and sensation seeking were found to be positively related to problem gambling, while lack of premeditation and lack of perseverance were unrelated. Multiple regression analyses revealed that positive urgency and negative urgency were the only significant predictors of problem gambling, suggesting that individuals who have the tendency to act rashly when in a positive or negative mood are more likely to display problem gambling behaviour. The results provide further evidence of the significant role of strong emotions in problem gambling. Further, it appears that problem gambling can be motivated both by the impulsive desire to avoid negative mood states and by the impulsive desire to maintain and enhance positive mood states.     

Multidimensional Assessment of Poverty Alleviation in a Developing Country: A Case Study on Economic Interventions

Donors increasingly expect international nongovernmental organizations (INGOs) to prove that the organizations' economic development interventions alleviate poverty. Currently, many INGOs search for new methods to meet this demand by focusing on the expectations of donors rather than those of beneficiaries. We analyze the benefit of qualitative, context‐specific methods and ask the question: What can an economic development intervention contribute to poverty alleviation from the perspective of the beneficiaries? In our case study, a negative economic valuation was not automatically a reason to evaluate the economic intervention as a failure. Assessment thus cannot be reduced to economic impacts. Also, qualitative approaches can add beneficiary‐oriented data in a context in which accountability mainly focuses on donors. This beneficiary orientation likely leads to better accountability negotiations with donors. Three hypotheses introduce these results.     

Assessment of Children in Need in a Post-Soviet Context: Reflections of Child Protective Workers in Estonia

Child protective worker perspectives and principles are known to affect practitioner–-client interaction. However, there is little research on the principles underpinning workers’ assessment activities in transitioning post-Soviet societies where child protection is a relatively new field. This article presents the findings of a small-scale, qualitative study that explored the perspectives and principles that Estonian child protective workers utilize to inform their assessments. The respondents (N = 20) provided examples of real-life cases that reflected their assessment perspectives. The results indicated that too often workers’ assessments demonstrate an over-reliance on an authoritarian, deficit-based approach that does not sufficiently include family or child perspectives. Such an approach may suggest the lingering influence of philosophies that informed family policy during the Soviet occupation. Workers with advanced training in social work and strength-based practices were more likely to focus on family strengths, build collaborative relationships with parents and children, and report successful outcomes in their cases. This study underscores the potential influence of previous Soviet occupation on child welfare practices in Estonia and also the need for further training of the nation’s child protective workers.