Unheard voices,unmapped terrain: Care work in long‐term residential care for older people in Canada and Sweden

Daly T, Szebehely M. Unheard voices, unmapped terrain: care work in long‐term residential care for older people in Canada and Sweden This article aims to contribute to comparative welfare state research by analysing the everyday work life of long‐term care facility workers in Canada and Sweden. The study's empirical base was a survey of fixed and open‐ended questions. The article presents results from a subset of respondents (care aides and assistant nurses) working in facilities in three Canadian provinces (n= 557) and across Sweden (n= 292). The workers' experiences were linked to the broader economic and organisational contexts of residential care in the two jurisdictions. We found a high degree of country‐specific differentiation of work organisation: Canada follows a model of highly differentiated task‐oriented work, whereas Sweden represents an integrated relational care work model. Reflecting differences in the vertical division of labour, the Canadian care aides had more demanding working conditions than their Swedish colleagues. The consequences of these models for care workers, for older people and for their families are discussed.     

Sex differences in psychological distress,behavioural and emotional problems,and substance use in young people in out‐of‐home care

The aim of the study was to examine sex differences in self‐reported psychological distress, behavioural and emotional problems, and substance use in young people living in out‐of‐home care (OoHC). One hundred seventy‐six young people aged 12–17 years (females 53.4%) in OoHC in metropolitan Melbourne, Australia, were interviewed. Participants completed self‐report measures: Kessler Psychological Distress Scale, Strengths and Difficulties Questionnaire, and the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test—Youth Version. Girls had more OoHC placement instability over the past year compared with boys (p = .019). Compared with boys, the girls had significantly higher levels of distress (p < .001) (p = .007), were more likely to have self‐reported emotional symptoms (p < .001) and peer relationship problems (p = .043) and were more likely to use sedatives (p = .004). Girls had more psychological distress, behavioural disturbance, and sedative abuse; placement instability might contribute to these problems. Greater integration across OoHC, mental health, and substance use sectors is required. Girls in OoHC may benefit from interventions targeting problems with peer relationship and substance use and supporting prosocial behaviour; such targets may reduce distress and emotional symptoms and possibly prevent longer term problems.     

Young care leavers' expectations of their future: A question of time horizon

This paper investigates young care leavers' expectations of their future after discharge from care. The results are based on qualitative longitudinal data where 16‐ to 21‐year‐old care leavers (n = 15) were interviewed twice, first when still in care but planning for their discharge (T1) and the second time 6–9 months later (T2). The analysis using a general inductive approach showed that their expectations were dependent on the time horizon and that there was an obvious difference between the young informants' short‐ and long‐term expectations. Their short‐term expectations consisted of worries connected to their approaching discharge (at T1) and how to cope with challenges of everyday life after discharge from care (at T2). These results seem to echo negative outcomes shown in previous quantitative research. However, the informants' long‐term expectations provide a different picture, being mainly positive in both interviews (T1 and T2). The results are discussed from a life course perspective, where the informants' visions of their future are framed and understood in terms of the different stages of their transition process.     

Perspective‐taking and gift‐giving in Chinese preschool children

This study explored Chinese preschool children's perspective‐taking via a gift‐giving paradigm. Unlike findings with North American children (Atance et al. in, Dev Psychol 46:1505–1513, 2010), the results from two experiments (N_{Exp. 1} = 329; N_{Exp. 2} = 112) showed that allowing Chinese children to first choose a desired object for themselves did not enhance their subsequent perspective‐taking performance in gift selection or gift justifications. This was true regardless of gift type (consumable or recreational items) or of recipient (mom, teacher, experimenter, or friend). In addition, children's perspective‐taking did not correlate with their performances in behavioral inhibition and delay of gratification tasks. These results suggest the possibility that the prior desire fulfillment effect varies with children's socio‐cultural experiences. Finally, Chinese children showed better perspective‐taking in choosing consumable gifts (e.g., drinks, snacks) than recreational gifts (e.g., toys, magazines), although this effect was not found for gift selection in Experiment 2. One interpretation of these results is that children's capacity for prosocial perspective‐taking is influenced by socio‐cultural experiences and social knowledge about individuals' preferences for different kinds of objects.     

Introducing social insurance for long‐term care in Taiwan: Key issues

Nadash P, Shih Y.‐C. Introducing social insurance for long‐term care in Taiwan: Key issues Taiwan will shortly complete its comprehensive social safety net, which includes national health insurance, retirement security, and unemployment insurance, by introducing long‐term care (LTC) insurance – putting it ahead of the many countries that rely on a patchwork of policies to address the need for LTC. The program, to be implemented in 3 to 5 years, will cover all citizens on a primarily social insurance basis. The range of LTC policy options considered is discussed, particularly how to structure the program, how to finance and regulate it, and how to develop its inadequate LTC infrastructure and workforce. Particularly thorny issues include the choice of social insurance, the feasibility of cash benefits, and how to address Taiwan's heavy reliance on foreign workers. Taiwan's increasingly democratic character, along with high levels of public support for the program, creates significant pressure on politicians to deliver on their promises to implement LTC reform. Key Practitioner Message: ?Emphasizes the importance of policy learning from other environments; ?Highlights the need for a strong regulatory and provider infrastructure for delivering long‐term care services; ?Emphasizes the need for training, support, and appropriate regulation of the long‐term care workforce.     

Self‐report of emotional experience and peer nominations of expressivity: Predictability of change in teacher‐rated social behavior

We investigated individual differences in self‐reported emotional experience and peer‐perceived expressivity among children in mid‐ to late‐elementary school years. Specifically, we examined the constructs’ correspondence and temporal stability and also compared the degree to which each predicts change in classroom social behavior over 2 years. Participants were 199 children (Mage = 10 years, Time 1) and their classroom teachers who have participated in two times of assessment. We used self‐report of emotional experience and peer nominations of expressivity regarding happiness, anger, and sadness. Teachers rated children's social skills, externalizing problems, and internalizing problems. The correspondence was generally small in magnitude between self‐reported experience and peer nominations of expressivity. The stability of peer nominations of emotional expressivity was medium and comparable to that of self‐reported experience with the exception of happiness. The predictability of change in social behavior was more robust for peer nominations of expressivity than for self‐reported experience. We discussed the relevance of different dimensions of emotionality as well as informants in understanding the predictability of social behavior from emotionality. We also discussed the role of sociodemographic variables in emotional experience and expressivity and offered practical implications of peer nominations in the assessment of children's emotionality.     

Emotional kinship care and neutral non‐kinship care — the struggle between discourses

In this paper, social workers' ideas of kinship care and non‐kinship care as foster placement alternatives for vulnerable children are analysed and discussed. The study is based on group interviews with Swedish social workers, using a discourse analytic approach. The interviews took two vignettes of children who needed an immediate and long‐term placement because one of the parents had killed the other parent, as their point of departure. Domestic violence is a common social problem across countries, and controversies about placement alternatives become even more apparent when discussing lethal violence. The analysis revealed three main discourses: ‘emotional kinship care’, ‘neutral non‐kinship care’ and ‘a real family’. The emotional kinship care discourse also revealed two competing sub‐discourses: ‘emotions as glue that binds’ and ‘emotions as obscuring a child perspective’, displaying a struggle concerning the advantages and risks that social workers connected to kinship care. In this paper, the results and their implications for vulnerable children are discussed.     

Person‐centredness in the community care of older people: A literature‐based concept synthesis

‘Person‐centredness’ is a ubiquitous term, employed in modern care services to signify policies and practices that attend to the uniqueness of each individual user. Despite being highly regarded in older adult community care services, there is much ambiguity over its precise meaning. Existing reviews of person‐centredness and its attributes have tended to focus on the medico‐nursing literature, neglecting other interpretations, such as those relevant to community social care. A new literature‐based concept synthesis reported here identified 12 common attributes within the broad themes of ‘understanding the person’, ‘engagement in decision‐making’ and ‘promoting the care relationship’. The review also contrasts how these attributes are applied across different interpretations of person‐centredness. The article argues that not all attributes necessarily pull in the same direction, and that older adults may require them to be delivered in different ways than they are to younger people. Thus, a ‘one‐size‐fits‐all’ approach should be discouraged in community care. Key Practitioner Message: ? ‘Person‐centredness’ is open to multiple interpretations, causing difficulties for services trying to gauge performance and quality; ? Three themes are central to person‐centred services: ‘understanding the person’, ‘engagement in decision‐making’ and ‘promoting the care relationship’; ? A ‘one‐size‐fits‐all’ approach to applying person‐centredness is to be discouraged.     

Citizens' views in four jurisdictions on placement policies for maltreated children

Citizens' opinions on child protection public policy are a key dimension of the legitimacy of a political order. We have conducted a survey vignette on a representative sample of citizens (N = 4,003) in England, Finland, Norway, and California, USA. The findings show that citizens' opinions are clearly in favour of adoption (75%) rather than long‐term foster care (25%). Context may partly explain the findings, as the responses of the majority of Anglo‐American respondents are in line with practice in their countries but for the Nordic respondents, there is a substantial discrepancy between citizens' opinions and on‐going child protection practices.     

Needs and availability of support among care‐leavers: A mixed‐methods study

Data are scarce on the long‐term needs of care‐leavers and on the support resources that are available for them in the years after leaving care. This mixed‐methods study presents data on the needs and availability of support of 222 Israeli care‐leavers, suggesting that the most urgent needs of care‐leavers are a lasting need for a stable and available support figure and assistance with educational issues. For some care‐leavers, these needs are fulfilled by their mentors. Parents and other familial figures were found to be the most common support resource for care‐leavers, which highlights the need for the intervention of social workers to improve relationships within families while the children are still in care. Due to high rate of young people who have no support resources and a low rate of services utilization, social services should provide a platform to support this group, using mentors and other supporters. The longitudinal data of up to 4 years after leaving care indicated that the availability of various types of informal support improved over the years, and the reports on difficulties in relationships of the care‐leavers with their parents were significantly fewer 4 years after leaving care than on the verge of leaving care.     

Organizational factors and child participation in decision‐making: differences between two child welfare organizations

Children in residential care tend to be less content with the quality of care arrangements and participation opportunities compared to children in foster care. This study explored possible differences in social workers' views about child participation and service quality. Hierarchical regression analyses were used to test if any differences may be explained by collaboration between professionals' and social workers' work engagement. We found that social workers from residential care services seem more prudent in letting children participate in case planning compared to social workers planning for foster care. Social workers' judgements of service quality were also highly affected by their organizational affiliation, but personal factors such as work engagement may also play a part. The differences we found regarding social workers' attitudes towards participation and their rating of service quality are associated with organizational culture. Understanding how organizations shape social workers' decisions to include or exclude children in care planning may help gain a more comprehensive understanding of what is needed to take the participation agenda forward.     

The key role of positive parenting and children’s temperament in post‐institutionalized children’s socio‐emotional adjustment after adoption placement. A RCT study

Parenting interventions represent a means for experimentally inquiring socio‐emotional change of post‐institutionalized children after adoption. We used this approach in a three time point RCT study involving 83 post‐institutionalized children (M_age = 33.5 months, SD = 17.1) and their adoptive mothers (M_age = 42.6, SD = 3.9), attending either the Video‐Feedback Intervention to promote Positive Parenting in adoption and foster care or a dummy intervention. Controlling for gender and age at adoption, children showed a significant change in their socio‐emotional adjustment in the specific variables inquired—that is, emotional availability‐EA, and behavioral problems—after intervention attendance. Mediation and moderated mediation models showed that maternal EA was a main factor affecting children’s EA and externalizing behavioral problems, with a key moderating role played by children’s temperament; children with high scores on temperamental negative affect benefitted most from their mothers’ increase in EA.     

Social Workers' Use of Spiritual Practices in Palliative Care

Abstract

Numerous studies have examined client use of spiritual and/or religious practices to cope with illness and adversity. This study explores social workers' use of spiritual practices as reflected in their work with palliative care clients. Survey results (n = 327) indicated significant relationships of spiritual practices such as yoga, prayer and meditation to working with palliative care clients. The total number of these approaches is predicted by factors such as theoretical orientation and the social workers' own struggles with palliative care and other issues. Our study supports the need for additional investigation of spiritual issues in practice.     

Older Persons’ Views on Using Cash‐for‐Care Allowances at the Crossroads of Gender,Socio‐economic Status and Care Needs in Vienna

The article aims to contribute to understanding social inequalities resulting from familization (or de‐familization) tendencies among cash‐for‐care beneficiaries in a Conservative welfare state. It highlights justifications for choices in accessing and using care in a cash‐for‐care scheme from the perspective of care recipients aged 80 years and older in Vienna. Along key dimensions characterizing care recipients’ experiences, we identify four different user groups, which reflect recipients’ individual characteristics, particularly gender, socio‐economic status (SES), and care needs, and the respective care arrangement. The groups are dubbed: (1) the self‐confident; (2) the illiterate; (3) the dependent; and (4) the lonely. Narrative interviews with 15 frail older people were held in 2014 and analyzed using the framework analysis method. Results show that familiarity with support structures associates with higher SES, while those who depend on others for acquiring information or organizing care express ambivalence in choosing between formal and informal care. Engagement in deciding which care type to use is limited among people of lower SES or with complex care needs, but own experience as informal caregiver for a family member increases care recipients’ long‐term care (LTC) system literacy. Gender differences among care recipients were limited, yet middle‐class female recipients often expressed normative claims for family care from female relatives. We conclude that unconditional care allowance schemes may reinforce existing gender relations, particularly among informal caregivers, as well as underpin socio‐economic differences among LTC users in old‐age. Results also partly question the assumptions of choice and empowerment implicit in many cash‐for‐care schemes.     

Using a “child's‐eye view” of social success to understand the importance of school readiness at the transition to formal schooling

Recent research into school readiness has highlighted the importance of not only children's cognitive and socio‐emotional skills, but also the degree to which they have family support in the home. The current study examines the association between social success upon school entry and teacher‐ratings of school readiness as assessed by the Brief Early Skills and Support Index (BESSI), controlling for language ability. Importantly, social success was assessed using a “child's‐eye view” with peer‐reported assessments of both social preference and reciprocated friendships. A total of 244 children (131 boys, M_age = 61 months, SD = 4.78 months) in their first year of formal schooling participated. Child school readiness was found to be important for social preference, with the association being more marked for boys versus girls. Family support was the only independent predictor of children's reciprocated friendships. The use of the BESSI, with its broad scope compared to other measures of school readiness, highlights the importance of focusing both on a child's cognitive and socio‐emotional skills at school entry and their family support when exploring the association of school readiness to children's social success at the transition to formal schooling.     

The Attitudes of Social Work Students Toward End-of-Life Care Planning

This study examined the attitudes of social work students toward end-of-life care planning, as well as their degree of willingness to engage in this area of social work practice. Factors associated with their attitudes were measured through structured surveys completed by 102 social work students (N = 102) at a school of social work in the southeast. Results indicated that these social work students tended to have positive attitudes toward end-of-life care planning in general. Moreover, these attitudes were positively associated with preference for pain relief treatment, higher levels of comfort when discussing death, more emphasis on self-determination, and apprehension of conflicts of self-determination. The results of this study underscored the increased societal need for recognition of personal preferences in end-of-life care, higher levels of comfort when discussing death, and an increased commitment of social workers' to maintaining the ethical principle of the client's right to self-determination in end-of-life planning. While this is not surprising, it points to a continuing need to re-assess where the field stands in its preparation of social work professionals who will work closely with people who are dying and their families.     

Mind‐mindedness and self–other distinction: Contrasts between Japanese and British mothers’ speech samples

To elucidate cultural contrasts in children's family environments, we conducted in‐depth, direct comparisons of mind‐mindedness and self–other distinction from maternal speech. The study included 5‐min speech samples of 225 mothers from Japan (N = 111) and the U.K. (N = 114) talking about their 3‐ to 6‐year‐old children (including 11 sibling pairs, n = 236). Compared with Japanese mothers, British mothers spoke significantly more, gave a significantly higher proportion of child‐focused and mind‐related comments, and also showed a stronger self–other distinction. In addition, within each country, there was a positive relation between mothers’ references to children in the singular (as opposed to plural) form and their mind‐mindedness. Together, the current findings highlight cultural variations in maternal mind‐mindedness, explicit–implicit communication style, and self–other distinction, and also suggest further exploration of relations among them.     

Foster care in France: children's perception of their own well‐being

Working to improve the welfare of children in care is a priority shared by all French child protection services. However, the means to measure and improve well‐being are limited (Fergeus et al., 2019). Although the trend today is towards a more comprehensive understanding of the point of view of adults involved in the socioeducational process, too little is done to include the children's own perception of their situation and conditions of care. The purposes of this study are to document and analyse the point of view of children in foster families on their subjective well‐being and also to identify contextual factors that influence it. Ninety‐one children living in foster care, aged 13.5 years on average, completed the French version of the Multidimensional Students' Life Satisfaction Scale developped by Huebner, Zullig Runa in 2012. The multidimensional evaluation of well‐being (family, school, self, friends, and living conditions) reveals a moderate life satisfaction within the foster family and a weak one at school. Total life satisfaction levels are directly linked to the number of care orders the child has experienced, their duration, and the type of education received. The implications of these results for professional practices related to children in care will be discussed.     

The turn to optional familialism through the market: Long‐term care,cash‐for‐care,and caregiving policies in Europe

Cash‐for‐care (CfC) schemes are monetary transfers to people in need of care who can use them to organize their own care arrangements. Mostly introduced in the 1990s, these schemes combine different policy objectives, as they can aim at (implicitly or explicitly) supporting informal caregivers as well as increasing user choice in long‐term care or even foster the formalization of care relations and the creation of care markets. This article explores from a comparative perspective, how CfC schemes, within broader long‐term care policies, envision, frame, and aim to condition informal care, if different models of relationships between CfC and informal care exist and how these have persisted or changed over time and into which directions. Building on the scholarly debate on familialization vs. defamilialization policies, the paper proposes an analytical framework to investigate the trajectories of seven European countries over a period of 20 years. The results show that, far from being simply instruments of supported familialism, CfC schemes have contributed to a turn towards “optional familialism through the market,” according to which families are encouraged to provide family care and are (directly or indirectly) given alternatives through the provision of market care.