Disability facilitators' views of their work with children/youth with disability in South Africa

Children and youth including those with impaired body function or structure, in under resourced areas, can be disadvantaged in terms of education and health care, and can experience social hardship. Within South Africa, personal, health and education support to individual children and their families in under-resourced areas is provided by care workers from the National Association of Child Care Workers. This organisation also provides training and support to their care workers to take on the role of Disability Facilitator, to extend their services to children with impaired body function or structure. This study established the views of Disability Facilitators about their work. Fourteen participants (aged 25–54 years) were individually interviewed at their own worksite. Two themes were identified from the data - Empowerment and Burden of responsibility.The theme of ‘Empowerment’ encapsulated how participants viewed disability more widely than as it relates to impaired body function and structure. Disability Facilitators empowered children and their families in a holistic way, and advocated within their community to address negative perceptions about disability. They supported the wellbeing and participation of children with disability within their local communities, and perceived their work as motivating and worthwhile. However, the second theme ‘Burden of responsibility’ encapsulated the challenges in feeling solely responsible for disability support in their community and in providing care and support for children living in dysfunctional families. They recommended all care workers receive training about disability issues to reduce the burden of responsibility on themselves. This study has demonstrated the worth of Disability Facilitators to address the challenges inherent in disabling environments. This approach to service provision offers useful insights that could be adapted into other countries and contexts.     

Accounts of professional and institutional tension in the context of Swedish elderly care

This article describes need assessment dialogues, the circumstances surrounding care, and the provision of residential care and in-home support for the elderly in Sweden, as seen from a communicative perspective. The purpose was to systematically describe and analyse the accounts of welfare officers concerning elderly care. The research questions were: How is the internal care context perceived and constituted through discourse? How do welfare officers manage the daily demands, expectations, tasks, and dilemmas in the encounter with the individual citizen? What significance do the welfare officers give their work and their professional tasks?Eleven interviews with welfare officers from elderly and handicapped care organisation of three municipalities were held, and a discursive analysis was made from the collected data. Four characteristic discursive phenomena in the welfare officers' accounts were observed: (I) the rights of the elderly, (II) living at home, (III) good relations, and (IV) the complaisance. The study shows that the dialogues with elderly contain communicative dilemmas and mixed loyalties. The welfare officers navigate between different perspectives and double approaches. She/he uses the navigating as a strategy and proficiency in their work. However, these proficiencies remain largely unnoticed and unreflected as techniques, strategies, or tools for attaining favourable care.     

Motivations for Providing and Utilizing Child Care by Grandmothers in South Korea

The purpose of this study was to construct a conceptual understanding of the motivations of grandmothers and mothers to provide and utilize child care by grandmothers in Korea. Grounded theory methods were used to collect and analyze interview data with 21 matched pairs of caregiving grandmothers and employed mothers. The grandmothers' motivations were concern for their adult children's well‐being and a feeling of responsibility to fulfill their parental responsibility for support. The mothers' motivations were the benefits they received as employed mothers and their trust of family care with prior expectations of the grandmothers' support. The core category integrating the findings was bilateral familism supporting traditional gender role ideology. The results suggest that changes from patrilineal to bilateral kinship interactions have been largely based on the influence of familism, which has created a cultural setting of expectations for downstream intergenerational support to maintain traditional gender roles despite increased maternal employment.     

Is anybody there? Informal supports accessed and sought by youth from foster care

Young people's ‘ageing out’ of foster care has been described as stark and abrupt, in sharp contrast with the gradual process of transitioning to adulthood experienced by parented youth in the general population. Research has demonstrated that being supported during this transition is associated with a variety of health, social, and educational outcomes. The purpose of this article is to report former foster youths' perspectives on their informal supports, what difference these supports made for them, and what they believed would be useful in their transition to adulthood. Data came from semi-structured interviews with 43 former foster youth aged 19–26. Findings revealed that while approximately half the informants reported having support from family, most did not have family whom they regularly relied upon for emotional, practical and/or financial support. Further, while nearly all youths indicated that having support made a difference to them, many also noted that for daily living, they were on their own. The study's findings are an important reminder of the gulf existing between youth from care and parented youth in terms of their access to support during their journey to adulthood.     

Rural communities and well‐being: a good place to grow up?

This study looks at young people's accounts of life in communities in rural northern Scotland, and considers in what ways affective and social aspects of community are bound up with well‐being, over and above young people's concerns for the future, rural youth transitions, and out‐migration. Interviews were held with 15–18 year‐olds in four study areas (16 groups, N=60+) and a parallel survey of 11–16 year‐olds was conducted in eight study areas (N=2400+). Themes to emerge from the interviews included: opportunities locally, the future and staying on, as well as local amenities and services; but older teenagers also spoke at length about their social lives, family and social networks, and their community, both as close‐knit and caring and as intrusive and controlling. Rural communities were seen as good places in childhood, but not necessarily for young people. In parallel with that, the survey data paints a picture where feelings of support, control, autonomy, and attachment were all associated with emotional well‐being. Importantly, links between emotional well‐being and practical, material concerns were outweighed by positive identifications of community as close‐knit and caring; and equally, by negative identifications as intrusive and constraining, where the latter was felt more strongly by young women. Certainly, beliefs about future employment and educational opportunities were also linked to well‐being, but that was over and above, and independently of, affective and social aspects of community life. Additionally, migration intentions were also bound up with sense of self and well‐being, and with feelings about community life; and links between thoughts about leaving and community life as controlling and constraining were, yet again, felt more strongly by young women. Thus, gender was a key dimension affecting young people's feelings about their communities with significant implications for well‐being, and out‐migration. The study illustrates the importance of understanding the experiences young people have of growing up in rural areas, and how they evaluate those experiences: particularly, how life in rural communities matters for young people's well‐being; and especially, for young women.     

What do the parents of tomorrow know about child care? A survey of 14–16 year olds

What do the parents of tomorrow know about child care? This study aimed to obtain a baseline measurement of child care knowledge, to ascertain any differences in knowledge between adolescents with and without mild to moderate learning difficulties (MLD). In addition, we were interested to establish the effect of school nurse health education health input on knowledge in the learning difficulties subgroup. Assessment was by self‐completed questionnaire and interview of a random sample of 14–16 year olds attending mainstream and special schools. Sixty pupils from secondary school and 33 from a MLD school took part in the study. Pupil knowledge in basic parenting and child care was dependent on the type of school attended, reading ability of those attending the MLD school and the provision of health education in the special school by the school nurse. No associations were found between pupils knowledge and their gender, family position or family size. Pupils from both schools scored lower in the areas of health service organisation and personnel, health promotion and management of common childhood conditions. Adolescents have insufficient knowledge of basic child care and services available for new parents. The effect of school based health education in these areas is promising. Copyright © 2001 John Wiley & Sons, Ltd.     

An intensive perinatal mentalisation-based intervention for women at risk of child removal and the role of restorative relationships

Pregnant women with a history of child removal are at greater risk of being found unsuitable to care for their new babies. Neglect, showing a lack of capacity to provide for the child's physical and/or emotional needs, is the most frequent reason why infants are removed from their parents' care. Parents with a history of child removal have often been themselves subject to maltreatment as children and suffer the sequelae of relational trauma which then becomes a barrier to establishing nurturing relationships with their own children. Attachment, and particularly mentalisation-based, parenting interventions focus on restoring relationships by developing parents' capacity to reflect upon their own internal mental experiences as well as those of the child, helping them to better understand themselves and their children. The DAISY programme is an intensive perinatal attachment and mentalisation-based intervention for pregnant women with a history of child removal, aiming to improve mothers' mentalising capacities and care proceeding outcomes. This article uses a case study to describe the programme's model and mechanisms of change. Additionally, we present preliminary observations about the programme's delivery and impact from the perspective of one of its practitioners.     

Families' experience of a single session therapy framework in advanced allied health practice for children with neurodevelopmental and behavioural disabilities: A thematic analysis of qualitative data

Single session therapy (SST) has emerging evidence for facilitating meaningful therapeutic change in a small number of consults, rather than more traditional long-term therapies. This study aimed to explore and describe the parent/caregiver and child experience with advanced allied health practitioners (AAHP) using SST for children with developmental disabilities, by understanding key characteristics of the consultation that led to therapeutic change. Eligible families attending an AAHP outpatient clinic for children with developmental and behavioural concerns participated in one to four SST consultations around their identified areas of need. Semi-structured interviews were conducted with 38 parents and 12 children, from 37 different families. Thematic analysis was used to analyse interviews. Demographic information was gathered through parent interviews and by reviewing hospital records. Four key themes emerged relating to the characteristics of the consultation that led to a positive experience for families: (1) the art of mutual presence; (2) the value of time; (3) the power of understanding; and (4) the trust of action. These attributes were influenced by the overarching complexities of the AAHP, the parent's and child's interpersonal skills, and the organisational mechanisms influencing patient care. Parents and children reported clinical change during the consult through increased understanding, and being heard, valued, and respected for their individual decisions on how to manage their child's and family's needs. This study provides preliminary evidence that utilising SST for children and families with developmental and behavioural needs facilitates a positive experience valued by families. SST, with a focus on a family's individual identified areas of concern, was valued and effective when delivered by AAHP. This suggests that SST, when appropriately administered by experienced and trained health practitioners, is useful for families dealing with children with developmental and behavioural challenges.     

Enhancing Critical Reflection amongst Social Work Students: The Contribution of an Experiential Learning Group in Care Homes for Older People

As part of a Practice Learning Centre, representing a partnership between an English University social work department and a non-governmental organisation, 12 students were placed in care homes for older people for their first period of assessed practice. The aims of this initiative were to facilitate: development of critical reflection; deployment of social work skills in a care home setting; and opportunities for social work students to work with care home residents. The learning was captured via four Experiential Groups facilitated by the Practice Educator with responsibility for assessing the students' practice. On-site supervisors also participated. Key learning included understanding of: the importance of critical reflection as a key social work skill; the influence of organisational norms and care home culture on the quality of care practice; the complexity and emotion-rich nature of person-centred care; and the pivotal role of relationships in work with people with dementia. Links made in the Groups—between the experiential and theoretical, the emotional and cognitive, and the structural and personal—demonstrate their value as learning platforms. Placements in care homes have considerable potential to enrich practice education; this is especially important in the context of an ageing population.     

Doing It All? Mothers' College Enrollment,Time Use,and Affective Well‐being

The rising share of women in college with dependent children and growing emphasis on two‐generation policies for reducing socioeconomic inequality have galvanized research aimed at determining whether mothers' increased education can improve their and their children's well‐being. Yet as part of this effort, scholars have overlooked signs that mothers' college enrollment may not be unequivocally good for families. This research brief aims to bring greater attention to this side of the story. The authors analyze time diary (2003–2015) and well‐being data (2010, 2011, 2013) from the American Time Use Survey. The authors find that mothers in college experience a time squeeze that limits their time in caregiving, self‐care, and work, on one hand, and school‐related activities, on the other. This time squeeze may explain why mothers enrolled in college (compared with mothers who were not in school) also reported less happiness and more fatigue during activities with their children.     

Do they get what they expect?: The connection between young adults' future expectations before leaving care and outcomes after leaving care

This study examines the future expectations of young people in out-of-home placements in the last year before leaving care and the association between those expectations and their outcomes after leaving care. The study examines the hypothesis that care leavers with higher future expectations will have better outcomes in the areas of housing, educational achievements, economic status, adjustment to military service, and life satisfaction. The study was conducted through 277 interviews with the young adults at their last year in care and 236 interviews a year after they left care. Higher future expectations while in care were positively correlated with satisfaction in accommodation, economic status and educational achievements and adjustment to required military service after leaving care. These findings emphasize the role of future expectations as a source of resilience and motivation. They also illustrate the importance of designing programs that address care leavers' self-perception and future outlook and offer preparation in concrete areas as the youth transition to adult life.     

Autonomy,Fairness and Active Relationships: Children's Experiences of Well‐being in Childcare

Researchers and policy‐makers are increasingly concerned with children's well‐being in Early Childhood Education and Care (ECEC) and Outside School Hours Care (OSHC) settings. Recent research identifies the value of using qualitative methods to understand children's experiences of well‐being in ECEC/OSHC, but there remain few such studies. This article presents findings from a child‐centric qualitative study with Australian children of nurses and police, which sought to understand their experiences of well‐being in ECEC/OSHC. Children's experiences of well‐being were shaped by parental relationships, how informed they were about the rationale for their care arrangements and the degree of age‐appropriate autonomy they experienced.     

Children’s perception of social boundaries: The intersectionality of age and social group affiliation in rural Pakistan

This study explores how children perceive social boundaries in rural Pakistan. It discusses that children develop and navigate their social relationships through their perception of social boundaries, which are shaped by kinship and sociospatial organisation in rural areas. Children's perception of social boundaries is also mediated through the intersectionality of their age and social group affiliation. An ethnographic case study of a village in Southern Punjab, Pakistan, is presented here. It uses a quantifiable photo-elicitation technique and social mapping to analyse children's everyday mobilities and intersectionality in the cultural context of rural Pakistan to illustrate their perception of social boundaries.     

Emancipation and Self-determination of People with Learning Disabilities and Down-sizing Institutional Care

In Arduin, an organisation for services to people with learning disabilities in the Netherlands, the emancipation and self-determination of people with learning disabilities has been positively adopted as fundamental in order to secure the best possible quality of life of the clients. The client is being encouraged in several ways in a development from a position of dependence towards self-determination. The services provided by the organisation had to be adjusted accordingly and are also going through a transition from 'providing a total care service' towards 'offering the support that the client desires'. In this article the background and developments in perception are being outlined, and those dimensions in quality of life are elaborated that are seen as most essential in the innovation: inclusion, self-determination and personal development. The choices that were made as a consequence in Arduin and most fundamental the choice to dismantle the institution are described.     

Health care,social care or both? A qualitative explorative study of different focuses in long-term care of older people in France,Portugal and Sweden

Challenges with an ageing population are increasingly becoming a reality in the Western world. Since cognitive impairment increases with age, we can expect an increasing number of older people in need of care. The aim of this article is to describe, analyse and compare different focuses on care of older people with dementia, using examples from France, Portugal and Sweden. The questions are principally focused on the participants’ view about their tasks, the organisation of work, the professional role and cooperation with other professions. Everyday care was studied through observations and participant observations and the staff's opinion was explored by means of interviews. Twenty-two care settings for older people were included. The findings showed that France provided mainly ‘health care’, Sweden ‘social care’ and Portugal an integrated ‘health care and social care’. In a comparative perspective the Portuguese general care of older people, which focuses on integration of health care, social care and social work, also seems to provide care for older people suffering from dementia which best corresponds to the previously developed group living model.     

NCH's Children in Danger campaign

SUMMARY. This article describes the thinking behind the National Children's Home's (NCH) Children in Danger campaign which began in 1985. It discusses the difficulties and benefits for a service providing child care voluntary organisation involving itself in social policy campaigning. The reasons behind the campaign are outlined, its implementation and its effects both on the public and the organisation.     

Financial Exploitation of Older Adults in Rural Settings: A Family Perspective

Federal agencies responsible for funding protective services to older adults are increasingly concerned with the growing incidence of financial exploitation in rural areas. The Wall Street Journal recently has reported an increasing trend of unemployed adult children migrating from urban centers to smaller rural towns and countrysides to live with their parents since 2008. This current study explores the attitudes of family caregivers regarding management of financial matters for their elderly care recipients. The major findings of the study include that adult children often (1) overestimate their parents' ability to manage their finances; (2) prefer to manage their parents' finances informally, as opposed to using legal options like power of attorney; and (3) tend to think of their parents' assets as “almost theirs.” The study concludes with recommendations on the critical need for information to help families make important decisions about helping elderly parents with their finances. This information would not only promote the use of safeguards against abuse, but could potentially provide caregivers with greater confidence and protection.     

Interprofessional collaboration in Swedish health and social care from a care manager's perspective

The aim of this study was to study interprofessional collaboration in health and social care for older people and persons with disabilities from a care manager's perspective. The empirical data was collected at a workshop held during a national conference for care managers and through focus group interviews in two Swedish municipalities. The results showed that the care managers collaborated in different ways with many different professionals from different organisations. The care and discharge planning meetings emerged as the most typical situation where care managers collaborated with different health care professionals. Interprofessional collaboration was seen as a means for care managers to fulfil their assignment and carry out their work. The care manager role encompassed role strain, a relatively weak professional identity, and differences in professional status among those involved in interprofessional collaboration.     

“The love that I was missing”: Exploring the lived experience of motherhood among teen mothers in foster care

The present study employed Interpretative Phenomenological Analysis (IPA) to explore the experiences and meaning of motherhood among teen mothers in foster care. Through a series of 18 in-depth, semi-structured interviews exploring experiences of both being mothered and mothering, the six young women in this study shared their stories of living the reality of becoming mothers under extremely challenging circumstances and doing their best to thrive. Themes of darkness and despair, (e.g., substance abuse, poverty, and child maltreatment) glimpses of light in the darkness (e.g., relationships with their partner's family), and new beginnings (e.g., identity as mother) emerged as characteristic of their experience. Implications for practice, policy, and research in the areas of teen pregnancy prevention and support for family strengthening are offered.