Abuses and Uses of Evaluation

In its recent report entitled Through a Glass Darkly, the Senate Standing Committee on Social Welfare claims that there is insufficient evidence available to evaluate welfare services, yet even within a brief paper this can be demonstrated to be not so. The Senate Committee however chose to ignore information about services as such, in order to discuss the process of evaluation. The apparent shortcomings of current services and the way the committee largely ignored these must be viewed in the light of the role welfare fulfils within the state—a role in which serving the interests of claimants is clearly not the major component.     

“As Needed” Case Management Across Aging Services in Response to Depression

A lack of clarity on how and where case management for older adults is delivered persists, even as evidence supports its use to respond to depression. We used in-depth interviews with managers (n = 20) and staff surveys (n = 142) from 17 service agencies to explore the provision of case management services in adult day services, homecare, senior centers, and supportive housing. Limited case management services were found. Barriers included limited time and resources, especially for senior centers and supportive housing. Results revealed a concern about the role, feasibility, and availability of case management for older adults within these settings.     

Core Programs and Services at Senior Centers

Senior centers have grown rapidly since the 1960's and are now a major element in community programs for older Americans. Despite their growth there has been little examination of what should be the minimum core of programs and services for all senior centers. A mail survey was undertaken to ascertain what senior center directors, staff and participants in Maryland viewed as the most important programs and services, the most helpful program and the reasons participants were originally attracted to the senior centers. The quantitative data collected was supplemented by focus groups with directors staff and participants. Based on the findings six core programs and services are recommended as well as optional services.     

Measuring Comprehensiveness of Services Provided at Child Day Care Centers

The service delivery patterns at child day care centers are classified and conceptualized in this paper along a scale of comprehensiveness. The services provided at the centers are dichotomized into basic and supplementary services. Supplementary services are grouped into developmental services; diagnostic, health and nutrition services; social services; and information and referral services. These categories are ranked according to their importance for day care clients. The unidirnensionality in this ranking is tested by the Guttman scaling method, and a scale of comprehensiveness is developed. A flow chart is then illustrated that provides an efficient method to assess comprehensiveness.     

Prioritising care services: Do the oldest users lose out?

Population ageing is a major concern in most European countries. Demands for health‐ and care services will increase, as older people typically have a higher need for such services. What is often overlooked, however, is that older users increasingly compete with younger users for the same limited care resources. We ask: How do employees in the Norwegian care sector make decisions regarding the allocation of services to younger and older users? To answer this question, we interviewed decision‐makers in Norwegian municipalities. Despite providing for equal rights to services, laws allow for an interpretation of needs and this can result in the unequal distribution of services. Our study indicates that needs are defined differently for younger and older users, which affects the amount, type and content of the services allocated to younger and older people. When resources are scarce and priorities must be established, the services to the oldest suffer. Key Practitioner Message: ● The article lays the groundwork for an open debate about the allocation of resources to users in different life phases; ● The analysis conceptualises and makes explicit important normative decisions made by practitioners.     

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

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

Adolescent fathers in urban communities: exploring their needs and role in preventing pregnancy

Reductions in the number of adolescent pregnancies in the US demand greater recognition of the role of adolescent males, especially in urban environments, and their developmental needs. With its person-in- environment orientation, the social work profession is in a strong position to ameliorate this gap in services. Key developmental issues for teenage males include "hanging out" with peers in networks that communicate information about social behaviors such as premarital sex, separation from one's parents, securing employment so that there can be financial independence, courtship and the consolidation of a male (e.g., macho) image, and identity formation. Since the resources necessary for positive identity formation are frequently unavailable in poor urban centers, impregnating an adolescent female may become an alternative source of self-esteem. Social workers should, with the assistance of the target population, carry out an assessment of all resources available in a given community to meet the developmental needs of adolescent males, identify significant gaps, determine the extent to which available resources are being used appropriately and develop strategies--in collaboration with young males--to provide access to existing resources or create new ones. A community forum framework has been most effective as a launching vehicle for pregnancy prevention programs.     

Motivation to volunteer among senior center participants

Senior centers in the United States play a vital role in the aging continuum of care as the focal points of a community-based system of services targeting independent older adults to promote their social integration and civically engagement. Although several studies have evaluated the diversity of senior center programs, demographic characteristics of participants, and benefits of participation, very few have explored motivations to volunteer among participants. Many senior centers rely on a cadre of participants who volunteer there to assist with programs and meal services. However, a systematic examination of volunteering interests and the rationale for volunteering among senior center participants has been missing from the literature. This mixed-methods study, conducted at a large suburban senior center, explores the interests and motivations of volunteerism among the participants. The study found that there was limited interest in volunteering among senior center participants. Those who were motivated to volunteer wanted to do so in order to stay connected with their community. There was strong interest in volunteering for single events or projects rather than a long-term commitment. Implications for senior centers are discussed.     

The Elder Latino Population in Holyoke,MA

Abstract

Holyoke's elderly Latino population's needs, as well as their patterns of service utilization, were explored through detailed interviews of 13 individual elders and a focus group of an additional 10 participants. The research uncovered a gap in the web of resources available, with some services, such as medical care, functioning well. However, there continue to be unmet needs, particularly in the areas of transportation, social and recreational activities, and sense of safety. Negative perceptions of aging and complaints of anxiety, depression, and boredom are also an area of concern.

The barriers to use of services were also explored. Recommendations for the enhanced provision and utilization of services, many suggested by the elders themselves, are offered. Implications for social work research and policy on, and practice with, Latino elders are discussed.     

Individual- and Contextual-Level Factors Affecting the Use of Social Support Services among Older Adults

ABSTRACT

By 2060, the number of Americans aged 65 and older is expected to more than double, while the number of Americans aged 85 and older is expected to nearly triple. As the nation's aging population grows, older adults will need to rely on social support services, such as transportation and housing services, in order to remain active and lead independent lives. In this study we use data collected from the elderly supplement of the Southeastern Pennsylvania Household Health Survey (SPHHS) (n = 3,042) to explore the relationship between the availability of elderly specific social service providers and utilization of social support services among older adults. We find that while the number of elderly specific social service providers can increase use of social support services among older adults, its impact is relatively minimal. We find that individual factors, instead, are stronger predictors of service use. This is a finding that should be particularly encouraging for elder care providers who may not have the resources needed to undertake large structural changes (like building new facilities). Still, future research should explore how the availability of a broader range of elderly specific social services (than explored in this study) impacts use.     

Service Users' Perspectives on the Benefits System in Israel: A Participatory Action Research

This article presents a position paper on Israel's benefits system. It was produced in the framework of a participatory action research with the collaboration of welfare services users and social welfare policy practitioners, academics, social practitioners, and social activists. Some 78 persons living in poverty, from various population groups, were asked, in group settings, to describe their experiences with the benefit system and services, their coping strategies, their perceptions and attitudes towards these services, and their recommendations for ways to improve them. The position paper which emerged from this process served as the basis for discussions between service users, social welfare policy practitioners, researchers, social activists and social practitioners at an academic conference. Issues such as benefits cuts, eligibility, and definitions of poverty are discussed and recommendations are presented.     

Treatment Barriers to Social and Health Care Services from the Standpoint of Female Substance Users in Finland

Abstract

This qualitative study discusses barriers affecting female substance user’s treatment access to welfare services. The study consisted of seven group discussions and three individual meetings with 13 women in Helsinki, Finland. Institutional ethnography was used as the theoretical framework for the study. The research questions are: (a) What treatment barriers do women face?, (b) What reasons are there for them not receiving services?, and (c) How do the ruling relations coordinate women’s experiences? Women faced multiple barriers affecting their access to services. They could be interpreted as being: determined by the service system, such as a difficulty in meeting the various criteria in order to be granted access to services; determined by the lack of trust; or determined by personal choices. The study suggests that the service system should be organized according to the needs of the service users. Future research is needed to address the questions such as how social and health care services could better co-operate, and how the different sectors of the service system could break down the institutional barriers.     

Senior Citizens Centers

Abstract

This study extends exploration of what senior centers offer, who participates, and what they gain. Center staff surveyed 856 participants in 27 senior centers regarding personal characteristics, program participation, and acquisition of vital information. Although senior centers are considered conduits for group activities and enrichment for older citizens, this investigation indicates that personal characteristics of participants exert a notable influence on the experience and perceived benefits of activities engaged in at senior centers. These findings should interest providers of aging services and advocates who view the senior center as an important vehicle for enhancing independent living for older adults.     

Support Systems of Widowed Women in Australia

The support systems that are used across the life cycle by women who become widowed were investigated in terms of (a) their frequency of use, and (b) problems for which support services were not seen as being available. In-depth interviews with 298 widowed women indicate relatively little use of organized social services for personal problems. In contrast, family and local doctors were called upon to help with a wide range of personal and economic problems. Many women had problems for which they perceived little or no help as being available in the community. Expectations of ‘front line’ professionals such as doctors, teachers and bankers for help and consultation were frequently not met. Implications of these findings for support systems are discussed.     

Senior Services that Support Housing First in Metro Vancouver

Housing First is a model and philosophy for housing homeless people in immediate and permanent housing. In order to implement and deliver Housing First, research is essential to understand the system of support services as they currently exist. Guided by principles of community-based participatory research, this paper presents the findings from a senior-focused deliberative dialogue workshop in Metro Vancouver, Canada. Participants (16 service providers and 1 service recipient) identified services and resources available to support seniors in maintaining housing and barriers and facilitators for accessing services. Broadly, data were organized into seven themes: (1) Housing; (2) Home support; (3) Transportation; (4) Information availability, accessibility, and navigation; (5) Cultural diversity; (6) Discrimination; and (7) Funding and financial support. Results found that affordable housing that adapts to changing health conditions, income supports, health services, homecare, transportation, and culturally appropriate and nondiscriminatory informational resources are among the supports most needed for persons as young as 50 years old to succeed under the Housing First model in Metro Vancouver. Barriers to Housing First service provision, including rigid eligibility criteria for chronically and episodically homeless, should be revised to better support the growing number of older adults who are newly entering homelessness in Metro Vancouver.     

Indigenous Elder Insights About Conventional Care Services in Alaska: Culturally Charged Spaces

Indigenous peoples around the world endure health and social disparities. In the United States, such disparities are typically ameliorated through conventional care services and organizations. Purpose: To examine points of tension that characterize culturally pluralistic care services in the United States, specifically Alaska, within context of Indigenous colonial histories. Design and Methods: The research design is ethnographic and multisited, comprising 12 months of fieldwork across urban, rural and remote village sites in Alaska. A conceptual lens that accounts for culturally diverse social spaces where relations of power are at stake frames research presented here. This work incorporates relational and participatory action research principles with Alaska Native Elders. Ethnographic evidence was collected through multiple methods, including field notes, documents, and interviews, with ethnographic analysis involving atlas.ti. Findings: Alaska Native Elders describe salient points of tension characterizing Alaska’s conventional care services through the following insights: generational curses-—a pain, prejudice on both sides—wounded, and value-systems clash—fighting. Conclusion: This article concludes with discussion about collective anxieties and implications for care services.     

Needs and Supports in Transitional Housing for People Living with HIV/AIDS in Ontario,Canada

ABSTRACT

There is a paucity of research on transitional housing for people living with HIV/AIDS (PHA) and even less so within the Canadian context. The present work addresses that gap and reports on the results from the Transitional Housing Study, a province wide community-based research collaboration involving PHA, service providers, and university researchers in Ontario Canada. This article answers the following research questions: What supports do residents in transitional housing for PHA access and what needs do these supports address? Developing from a thematic analysis of in-depth qualitative interviews with 25 residents in one of three transitional housing agencies in Ontario for PHA, the findings reveal that participants benefited from four key supports while in transitional housing: the provision of a safe environment, co-coordination and management of HIV (and other) drug therapies, assistance with appointments, and referrals to health and social services. Until more resources are available to increase availability of transitional housing for PHA, the nonprofit housing sector must fill the gap that exists by offering the types of supports identified in this study in order to address the needs of PHA. Future research may link these supports efficiently with concrete health improvements and permanent housing stability among PHA.     

Working with managers to improve services: changes in the role of research in social care

The setting of specific objectives for children's services and the identification of key outcome indicators, together with the development of a core information specification for children's services with its practical application in the implementation of the Integrated Children's System, all mean that substantially more data are now available to child welfare agencies. Not so long ago in the UK it was the role of research teams to collect and analyse such data. Now that so much of it is already available to agencies, are researchers who work in this area of applied social policy research becoming redundant? Using data from the cohorts of looked after children being studied at the Centre for Child and Family Research, Loughborough University, the paper demonstrates how researchers can work in consultation with the managers of child welfare agencies to make better sense of the data at their disposal. It considers three issues: what additional variables need to be explored to help agencies better understand their performance; how groups of children could be identified who follow predictable pathways through social care; and how qualitative information is necessary to gain a true picture of what is happening. All of these examples demonstrate a fundamental role for researchers in working with social services personnel to identify how services can be improved.