Migrant Care Workers or Migrants Working in Long-Term Care? A Review of Australian Experience

Discussion of the role of migrant care workers in long-term care (LTC) that has gained increasing attention in the United States and other developed countries in recent years is of particular relevance to Australia, where 24% of the total population is overseas-born, two-thirds of them coming from countries where English is not the primary language. Issues of interest arise regarding meeting LTC workforce demands in general and responding to the particular cultural and linguistic needs of postwar immigrants who are now reaching old age in increasing numbers. This review begins with an account of the overseas-born components of the aged care workforce and then examines this representation with reference to the four factors identified as shaping international flows of care workers in the comparative study carried out for the AARP Public Policy Institute in 2005: migration policies, LTC financing arrangements, worker recruitment and training, and credentialing. The ways in which these factors play out in Australia mean that while overseas-born workers are overrepresented in the LTC workforce, migrant care workers are not identifiable as a marginalized group experiencing disadvantage in employment conditions, nor do they offer a solution to workforce shortages. The Australian experience is different from those of other countries in many respects, but it does show that the experience of migrant care workers is not unique to LTC and points to the need to extend the search for solutions to workforce shortages and improving conditions of all care workers well beyond LTC systems to wider policy settings.     

The Concept of ‘Family’ Among Norwegian Adolescents in Long-Term Foster Care

In Norway, about 8,000 children live in foster homes (about 3.300 in age group 13–17). What does ‘family’ mean to these children? We explored the views and feelings about ‘family’ among 22 adolescents who are living in long-term foster care. Three patterns emerged. Most of the participants expressed confidence and adjustment in the foster home placement and felt bonded to both their foster family and to their birth family. Other adolescents expressed a strong sense of membership to their birth family but not to their foster family, and the remaining adolescents described a weak bond to birth family but a strong bond to their foster family. The main implications of the three patterns are discussed in the light of policy and practice.     

Tracing Stigma in Long-Term Care Insurance in Israel: Stakeholders’ Views of Policy Implementation

A rapidly expanding number of baby boomers provide care to aging parents. This study examines associations between caregiver status and outcomes related to awareness and anticipation of future long-term care (LTC) needs using 2007 Connecticut Long-Term Care Needs Assessment survey data. Baby boomers who were adult child caregivers (n = 353) versus baby boomers who were not (n = 1242) were more likely to anticipate some future LTC needs and to have considered certain financing strategies. Although baby boomer adult child caregivers more readily anticipate some future LTC needs, they are not taking specific actions. It is important to address the need for public education directed toward those who are currently (or have recently completed) caring for aging parents.     

What Works in Group Care? - A Structured Review of Treatment Models for Group Homes and Residential Care

This paper presents findings from a structured review of treatment models that are relevant to group care and residential treatment settings for children involved with the child welfare system. Initiated and guided by The California Evidence-Based Clearinghouse for Child Welfare, five treatment models — Positive Peer Culture, Teaching Family Model, Sanctuary Model, Stop-Gap Model, and Re-ED — were reviewed for effectiveness. In this paper, each model's treatment features are described and relevant outcome studies reviewed in terms of their effectiveness as well as relevance for child welfare practice. Findings indicate that four of the models are either supported or promising in terms of evidence for effectiveness. Implications for group care practice and research are discussed.     

Exploring the Domestic Homes of Sikhs in Finland as a “Cosmos of Senses”

The domestic home plays an important role in the process of socialization. In the context of migration, home becomes even more meaningful as a site for socialization, since it provides—next to the Internet, cultural events and places of religious worship—one of the few sites where young children can learn about their parent’s cultural and religious traditions in their new homelands. Grounded in data gathered through ethnographic fieldwork, this article seeks to gain a deeper understanding of the ways in which the domestic space of home is involved in the process through which young Sikhs who are growing up in Finland are made familiar with their parents’ religion. To reach this objective, I will examine home as a “cosmos of senses” that has been created by its inhabitants and the practices they perform in the course of everyday life. Applying the ethnographic lens in the study of the domestic home of Sikhs will also help us to gain a more profound understanding of Sikhism as a lived religion, as the findings presented in this article show.     

Citizens’ Jury and Elder Care: Public Participation and Deliberation in Long-Term Care Policy in Thailand

Health care policies for the elderly are complex, multidimensional, and contextually circumscribed. While engagement of health experts, economists, health care administrators, and political leaders is generally viewed as instrumental to the success and sustainability of eldercare programs, the elders themselves are often viewed as passive recipients of care and not included in the policy processes. Experiences and expectations from users’ perspectives can be invaluable information for policy formulation and systems design. This paper examines a participatory policy process using a “citizens’ jury” to promote public engagement in eldercare policy. The process was initiated by the National Health Commission Office in Thailand to explore how a citizens’ jury as a model for civic deliberation can be utilized to provide sophisticated policy recommendations on long-term care policies for the elderly. The objectives of this paper are to (1) examine how public participation in health policy can be actualized through the citizens’ jury as an operational model, (2) understand the strengths and weaknesses of the ways the idea was implemented, and (3) provide recommendations for further use of the model. Details of how a citizens’ jury was deployed are discussed, with recommendations for further use provided at the end.     

Challenges in Identifying Factors Which Determine the Placement of Children in Care? An International Review

Placing a child in out-of-home care is one of the most important decisions made by professionals in the child care system, with substantial social, psychological, educational, medical and economic consequences. This paper considers the challenges and difficulties of building statistical models of this decision by reviewing the available international evidence. Despite the large number of empirical investigations over a 50 year period, a consensus on the variables associated with this decision is hard to identify. In addition, the individual models have low explanatory and predictive power and should not be relied on to make placement decisions. A number of reasons for this poor performance are offered, and some ways forwards suggested. This paper also aims to facilitate the emergence of a coherent and integrated international literature from the disconnected and fragmented empirical studies. Rather than one placement problem, there are many slightly different problems, and therefore it is expected that a number of related sub-literatures will emerge, each concentrating on a particular definition of the placement problem.     

The “Our Homes,Not Nursing Homes” Project

ABSTRACT

The voices of non-elderly adults with disabilities who currently-or used to-reside in nursing homes are rarely heard. A grassroots disability advocacy organization conducts participatory action research in the form of a writing workshop in collaboration with a local community-college. Participants with disabilities describe their lives and their experiences in nursing homes with the help of volunteer scribes. The information provided in their accounts will help strengthen community-organizing efforts of the disability advocacy organization. And participants have been empowered by the realization that their life stories are helping others to leave nursing homes and join community settings.     

Factors Related to the Institutionalization of Older Aged Individuals Using Home- and Community-Based Care Services: Data From the South Korea Long-Term Care Insurance Program, 2008–2013

South Korea introduced a public long-term care insurance (LTCI) program in response to its rapidly aging population. This study analyzed the association between living arrangement and caregiver type with institutionalization in LTCI grade 1 (very severe limitations), 2 (severe limitations), and 3 (moderate limitations) beneficiaries using data from the LTCI cohort, 2008 to 2013. The dependent variable was alteration status from home to institutional care within 1 year of receiving home service. Independent variables were living arrangement and primary caregiver type. The analysis was conducted using the generalized estimating equation model. Higher likelihoods of institutionalization were found in individuals living with a non-family member compared to individuals living with their spouses. Individuals without a caregiver or with a paid caregiver were also more likely to experience institutionalization than individuals with a spouse primary caregiver. Our findings underscore the importance of monitoring identified vulnerable groups of individuals to attain LTCI sustainability and enhance elderly quality of life.     

Israel’s Long-Term Care Social Insurance Scheme After a Quarter of a Century

Long-term care social insurance schemes exist in a number of countries, while the introduction of such schemes enjoys some support in others. Israel’s long-term care social insurance scheme has been operating since 1988. This article examines the emergence, goals, design, and impacts of this scheme and draws out some of the lessons that can be learned from Israel’s quarter century experience of long-term care social insurance.     

The Dark Side of “The Nose”: The Paradigms of Olfactory Perception in Gogol'’s “The Nose”

The article focuses on the ways in which Nikolai Gogol'’s famous story “The Nose” can be viewed meaningfully after being designated as the token of nonsense and illogicality by representatives of structuralism and hermeneutics in Slavic studies. Instead of interpreting the story’s symbolic significance or establishing its connections to other texts, the present article examines the story literally and asks what it means to lose one’s olfactory capacity in the Russian capital in the first third of the nineteenth century. The article’s answer is that Gogol'’s story can be seen as marking the moment during which the traditional olfactory-rich values of Russian culture gave way to a more vision-oriented Western sensory paradigm that tended to denigrate the sense of smell and its cognitive potential.     

What Makes Association Members Donate More? Factors Influencing Members’ Donation Amount in Membership-Based Professional Associations

VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations - As charitable donations account for a significant amount of the revenue of professional associations, such associations...     

Making Sense of Meta-Analysis: A Critique of “Effectiveness of Long-Term Psychodynamic Psychotherapy”

Evidence-based practice depends in part on knowledge derived from relevant research. For any given topic, there are likely to be many, potentially relevant studies; a careful appraisal and synthesis of the results of these studies is needed to understand the state of the empirical evidence. Meta-analysis is widely used to combine results of quantitative studies; yet this method is unfamiliar to many people and, as a result, meta-analyses are often uncritically accepted. In this article, we argue that meta-analysis is only one component of a good research synthesis. We critique a recent metaanalysis on the effectiveness of long-term psychodynamic psychotherapy, showing that this metaanalysis failed to meet current standards for the conduct and reporting of systematic research reviews and meta-analyses. We demonstrate the use of AMSTAR, a straightforward tool for assessing the quality of systematic reviews and meta-analyses.     

Pre-foster Care Maltreatment Class as a Predictor of Maltreatment in Foster Care

The majority of youth in the foster care system have been removed from their homes as means of protection against parental maltreatment. Studies have shown, however, that foster youth may continue to experience maltreatment after they have entered the child welfare system (Poertner et al. in Child Youth Serv Rev 21(7):549–563, 1999; Tittle et al. in Urbana 51:61801, 2008). In this study, we explore how maltreatment prior to foster care entry may predict maltreatment while in care for youth who are preparing to emancipate. Using latent class analysis and multinomial logistic regression, we find that current or former foster youth with histories of multiple maltreatment (particularly, combined pre-foster care histories of neglect and physical abuse) are more likely to report neglect, physical abuse and sexual abuse in care than those with histories of low maltreatment. These youth should be the target of prevention efforts in child welfare agencies.     

Conditions for Exercising Residents’ Voting Rights in Long-Term Care Residences: A Prospective Multicenter Study

To assess voting conditions in long-term care settings, we conducted a multicenter survey after the 2009 European elections in France. A questionnaire about voting procedures and European elections was proposed in 146 out of 884 randomized facilities. Sixty-four percent of facilities answered the questionnaire. Four percent of residents voted (national turnout: 40%), by proxy (58%) or at polling places (42%). Abstention related to procedural issues was reported in 32% of facilities. Sixty-seven percent of establishments had voting procedures, and 53% declared that they assessed residents’ capacity to vote. Assistance was proposed to residents for voter registration, for proxy voting, and for voting at polling places, respectively, in 33%, 87%, and 80% of facilities. This survey suggests that residents may be disenfranchised and that more progress should be made to protect the voting rights of residents in long-term care facilities.     

Change in VA Community Living Centers 2004–2011: Shifting Long-Term Care to the Community

The United States Department of Veterans Affairs (VA) is facing pressures to rebalance its long-term care system. Using VA administrative data from 2004–2011, we describe changes in the VA’s nursing homes (called Community Living Centers [CLCs]) following enactment of directives intended to shift CLCs’ focus from providing long-term custodial care to short-term rehabilitative and post-acute care, with safe and timely discharge to the community. However, a concurrent VA hospice and palliative care expansion resulted in an increase in hospice stays, the most notable change in type of stay during this time period. Nevertheless, outcomes for Veterans with non-hospice short and long stays, such as successful discharge to the community, improved. We discuss the implications of our results for simultaneous implementation of two initiatives in VA CLCs.     

A Clinician-Researcher’s Understanding of “The Effectiveness of Long-Term Psychodynamic Psychotherapy”

Leichsenring and Rabung’s meta-analysis of long-term psychodynamic psychotherapy offers a useful summary of available research data. Their adaptation of meta-analysis has many merits as well as some important limitations. Their work provides preliminary support for the effectiveness of this therapy, a widely used method of treatment that also has detractors. The article also sets the stage for reviewing how the research ideology of evidence-based practice (EBP), and the economic forces behinds EBP, may limit research on several therapeutic methods of interest to clinical social workers and our clients. A call is made for additional high quality research on many therapies with considerable research support that may not (yet) meet the standards of EBP.