The effects of adapting their home on the meaning of home for families with a disabled child

This article describes part of a mixed-method study investigating family and professional perspectives on home adaptations for disabled children. The methods were an online survey of staff involved in adaptations processes (n =39), semi-structured interviews with families with disabled children (n = 48) and an online survey for families (n = 16). One of the wider study’s recommendations was that families need to be enabled to engage with processes proactively. This article focuses on families’ experiences of the meaning attributed to adapting the home and highlights that, although satisfied with the completed adaptation, families were dissatisfied with the process they had been through. Thus, despite the need for the meaning of home being central to the adaptation process, families felt excluded from the process as it progressed. This had a negative impact on the continuing use of the adaptation and affected the meaning of home for families with a disabled child.     

Beyond Clinical Complexity: Nonmedical Barriers to Nursing Home Care for Rural Residents

We conducted a qualitative content analysis of barriers to nursing home admission for rural residents. Data came from semi-structured interviews with 23 rural hospital discharge planners across five states (Georgia, Idaho, Minnesota, Pennsylvania, and Wisconsin). From those, we identified four themes around nonmedical barriers to rural nursing home placement with particular salience in rural areas: financial issues, transportation, nursing home availability and infrastructure, and timeliness. We also identified policy and programmatic interventions across four themes: loosen bureaucratic requirements, improve communication between facilities, increase rural long-term care capacity, and address underlying social determinants of health.     

Decision-Making Criteria in Child Custody Disputes That Involve Requests for Overnight Visits with Infants and Toddlers: Derived from a Review of the Literature

ABSTRACT

The court, child custody evaluators, and mediators are often faced with difficult decisions regarding how to best meet the needs of children from families who are involved in child custody disputes. In some cases, the court, child custody evaluators and mediators are asked to make decisions about parenting plans for infants and toddlers. When decision makers are faced with actual cases, they are likely to be assisted by lines of inquiry that help them gather the most relevant data to answer the question at hand. A review of the literature has led to the development of 13 criteria that decision makers can use to reach conclusions about whether overnight visits would be advisable with a given infant or toddler. The criteria are considered neutral and are not based on any bias or preconceived opinion about whether overnights with infants and toddlers are or are not advisable. Instead, the criteria proposed provide the decision-maker with an objective way of structuring their thinking about a particular case to insure that all pertinent information has been considered before reaching a conclusion about whether overnight visitation is in the best interest of a given child.     

Design Teams as Learning Systems for Complex Systems Change

Summary

Systems change in child welfare and cross-systems change involving other service sectors are needed in response to two developments: (1) New policy mandates (e.g., TANF, AS FA) and (2) Research on the co-occurring and interlocking needs of many child welfare families. A four-state initiative was structured in response to these needs. Collaborative learning and action research groups called design teams were structured to identify competencies and to develop new service delivery systems. Faculty facilitators representing social work education programs were assigned to these teams and charged with their development and evaluation. Facilitators served as linkage agents for university-communitystate agency partnerships, and they promoted curriculum change. These study reports two sets of findings related to these design teams: (1) Findings from semi-structured interviews of design team members; and (2) Findings from the participatory action research completed by two faculty facilitators. Key themes related to design team processes are presented. Drawing on these emergent themes, components that help explain effective design team processes are identified. Selected implications for social work education programs and faculty also are identified     

What students’ Facebook posts teach us about the identity challenge in field placements abroad

ABSTRACT

Facebook is a common tool that enables students to publicly express their emotions, thoughts, experiences, and knowledge. On the assumption that the personal narratives of students can provide deep insights into their learning processes during practical training programs, the article presents content analyses of Facebook posts written by Israeli students who participated in an international social work field placement program in India. Content analysis of the students’ posts reveals that they grappled with their personal and professional identities as part of the learning process that occurred while they were formulating their professional identity as social workers. The analysis elicited three main themes: (1) awareness of the national identity; (2) exploration of other identities (personal, professional, and global); and (3) an attempt to contain multidimensional identity. The students discussed the main challenges they faced in the process of formulating an identity that will enable them to engage in international social work, and they described the fluctuations that occurred in those identities. The results show how public Facebook posts can be used as a tool to shed light on the contribution of social work education in international field placements, and provide insights into the learning processes that students experience in field placements abroad.     

Professional discretion and length of work experience: what findings from focus groups with care managers in elder care suggest

ABSTRACT

Research has explored how care managers in elder care – who often function as ‘street-level bureaucrats’ – regard professional discretion. The way in which length of work experience affects care managers’ use of professional discretion remains, however, unexplored. This article present findings from 12 focus groups with 60 care managers. By bringing attention to how care managers experience the needs assessment process, this article sheds light on how these ‘street-level bureaucrats’ struggle when they try to balance their clients’ needs against institutional frameworks and local guidelines. Length of work experience seems to play a role in how care managers claim to use professional discretion. Experienced care managers describe how they deviate from the guidelines at times in order to create an increased scope of action in their decision-making process. Those with less time in the profession describe greater difficulties in this respect. Findings suggest that research should explore if length of work experience plays a role in the actual way in which care managers assess needs and make decisions. As such, they contribute to our understanding of how needs assessment processes are navigated by professionals while also pointing towards the nature of professional discretion in gerontological social work.     

Transformative Homes

ABSTRACT

In the era of global workflows and massive migrations, it has been suggested that the notion of home is breaking free from its material aspects to become a set of exportable routines and practices. On the other hand, it is argued that the materiality of spaces and objects can support migrants' well-being in the new destination. Drawing on the ethnography of a Moroccan household in Rome, Italy, we illustrate how actions pertinent to the material home can favor identity development and the exercise of agency. First, we discuss squatting as a collective action of appropriation and transformation, which led to the identification with a transnational, intercultural category of migrant. Second, we illustrate the activities of furnishing as the locus of syncretic and reflexive processes, in which elements of the host country and themes from the migratory experience are mixed and reinterpreted in novel ways. Our analysis supports the view that the materiality of the home and the actions it affords play a major role in the socio-psychological adjustment of migrants and—on a wider scale—in processes of cultural dynamism and renovation.     

Comparing Advice from Military Parents,Partners, and Veterans about How Families Can Encourage Service Members to Seek Behavioral Health care

This study compared advice that three groups—military parents, partners, and Veterans—gave regarding how military families can encourage service members (SMs) to seek professional help when needed. Based on identity implications theory and the normative model of social support, common themes regarding how families might pursue task, relational, and identity goals were expected (RQ₁). Based on their unique positions, we investigated whether the three groups stressed different themes (RQ₂). Military parents (n = 51), partners (n = 74), and Veterans (n = 112) read a scenario in which a SM was having difficulty reintegrating after deployment; all three groups offered advice about how military families should handle similar situations. Common themes regarding task, relational, and identity goals emerged in the advice from all three groups; however, parents, partners, and Veterans also differed significantly in how often they mentioned six themes. Theoretical and practical implications are discussed.     

Letters from the future: an exercise with child welfare predictions

Abstract

The article presents an empirical exercise about predictions in child welfare. In the exercise, social workers imagined letters which they could receive from a child and his/her parents in five years’ time. The children had been in care for one year at the moment of letter-writing. When the social workers wrote the imaginary letters, they used their professional imagination, based on practice knowledge and experience, and were involved in a role-play. The analysis of the letters (34 from ‘children’ and 33 letters from ‘parents’) demonstrates four themes shared by the letters: ordinary life, family contacts and return home, social problems as shadows and assessment of the placement. Two narratives were performed: the narrative of future of ordinary life and that of the troubles. It is suggested that imaginary letters are helpful in highlighting practitioners’ sense of the future, professional imagination as well as the empowering and critical points in practice.     

How do you solve a problem like Maria? Family complexity and institutional complications in UK social work

ABSTRACT

This paper draws on UK data from an international, comparative project involving eight countries. The study examined how social workers’ conceptions and definitions of family impact on the way they engage with complex families, and how social policies that frame social work context impact on the way social workers engage with families. Focus groups were held in which social workers from four service areas (child welfare, addictions, mental health and migration) were asked to discuss a case vignette. Several factors were embedded in the vignette to represent a realistic situation a social worker may come across in their day-to-day work. Social workers clearly identified the complexity of the family’s situation in terms of the range of issues identified and candidate ‘causes’. However, typical first responses were institutional, looking for triggers that would signify certainty about their, or other agencies’ involvement. This resulted in a complicated story, through which the family was disaggregated into individual problem-service categories. This paper argues that understanding these processes and their consequences is critical for exploring the ways in which we might develop alternative, supportive professional responses with families with complex needs. It also demonstrates how organisational systems manifest themselves in everyday reasoning.     

Professional Socialization as Embedded Elaborations: Experience,Institutions, and Professional Culture Throughout Teacher Careers

Across a wide range of studies on professional socialization, there is a shared assumption that people carry forward what they learn in formal training experiences and somehow bring it to bear on the subsequent organizational settings they enter. Yet we actually know very little about whether, and exactly how, people carry forward the meanings they develop as part of their professional socialization experience. We address this gap in the literature by examining professional socialization that unfolds over the teaching career. Combining interview data with public and private school teachers across career stages with ethnographic data of a university‐based teacher education program, we examine how the meanings people develop about their work are shaped concomitantly by accumulated experience and institutional settings. We develop a conceptualization of professional socialization that we call embedded elaborations, which attends to the ways that people's ongoing meaning making (or elaborations) is situated (or embedded) institutionally and temporally. We also show how embedded elaborations act as meaning‐making processes through which people in local settings actively produce and reproduce elements of a wider professional culture.     

The Cat is out of the Bag: The Joint Influence of Previous Experience and Looking Behavior on Infant Categorization

We examined the effect of 4‐month‐old infants' previous experience with dogs, cats, or both and their online looking behavior on their learning of the adult‐defined category of cat in a visual familiarization task. Four‐month‐old infants' (N = 123) learning in the laboratory was jointly determined by whether or not they had experience with pets at home and how much they shifted their gaze back and forth between the stimuli during familiarization. Specifically, only infants with pets at home who also exhibited high levels of switching during familiarization remembered the individual cat exemplars or formed a summary representation of those cats. These results are consistent with recent theorizing about the processes of how infants' categorical representations are formed, and provide new understanding into how infants' categorization unfolds over time.     

Disabling Spaces and Spatial Strategies: Feminist Approaches to the Home Environment of Family Caregivers of People with Dementia

ABSTRACT

The home environment becomes very important for family caregivers of people with dementia as a place of safety, retreat and care provision. Using a gender-based perspective, the authors analyzed thirteen interviews with family caregivers to understand how they perceived their home space. The data was analyzed thematically with the help of adjacency diagrams. Our analysis identified three main themes: compact layout, spatial flexibility, and the wider neighborhood. Given the gendered nature of caring, the findings are discussed drawing on the work of feminist architects regarding the home environment. The authors argue that feminist architectural approaches can usefully inform spatial strategies regarding dementia, ageing friendly housing, accessible living and the wellbeing of the caregiver. Different bodies and users’ needs should be at the epicenter of design, as opposed to conventional design and the current practices by developers, which may create a series of disabling spaces.     

Sense of home in a transnational social space: New Zealanders in London

In this article, I explore the ways in which ‘middling’ migrant New Zealanders living in London and New Zealand discuss and identify with home. For these multi‐local individuals, the discursive and material aspects of New Zealand as home form a framework for their everyday life as migrants living in London. Interpretation of the interviews using thematic and narrative analyses works through a conceptualization of home, migration, and identity as interdependent, through three interrelated themes: the symbolic or political nature of home; the importance of family and familiarity for a sense of home; and the role of physical material objects and places. Participants in this study see New Zealand as their home, yet by being away from home they gain new perspectives on home. In London, they engage with or resist a collective imaginary of New Zealand as home that is both self‐perpetuated and externally imposed, and which both reveals and conceals ideas about individual and group identity and community. On returning from London, the idealistic and sometimes simplistic visions of New Zealand as home that structure their lives in London are often disrupted by the more complex yet more mundane version of home and self with which they are confronted.     

Factors affecting user participation for elderly people with dementia living at home: a critical interpretive synthesis of the literature

ABSTRACT

Professional caregivers are expected to facilitate user participation for people with dementia. At the same time, an increasing number of elderly people with dementia are now being cared for at their homes. Research is scarce on user participation for people with dementia, especially for people with dementia who live at home. This article aims to systematically and critically review the factors affecting user participation for elderly people with dementia living at home from the viewpoint of the patients, family caregivers, professional caregivers and researchers. A systematic literature search and critical interpretive synthesis were conducted. The search yielded 1,957 articles. In total, 112 full-text articles were retrieved, of which 27 met the inclusion criteria. Five broad analytical themes were identified during the analysis: individual characteristics, professional caregiver characteristics, decision characteristics, relational characteristics and organisational characteristics. The results show that the value placed on user participation can differ between family caregivers and professional caregivers. People with dementia still experience stigmatisation, preventing user participation, and relations with both family and professional caregivers play a key role in enabling user participation for people with dementia.     

Sustaining an intimate and sexually fulfilled marriage or partnership in older adulthood with a disability: Perspectives of social workers

ABSTRACT

The American portrayal of sex is often left for only the young, attractive, and able-bodied. In contrast many studies have found that older adults with disabilities in marriages and intimate partnerships have sexual desire and sexually active lives. Social workers are often burdened with balancing the sexual intimacy desires of their older adult clients with disabilities, alongside the need to protect them from sexual abuse and exploitation, particularly among those who may lack the capacity to consent due to cognitive impairment. This phenomenological study aimed to understand the lived professional experience of social workers (N = 5) in supporting married and intimately partnered couples in which at least one person was an older adult with a disability to understand the clients’ needs and common social work practice methods used to address their needs. Inductive coding was used to identify themes and subthemes. Their role included helping their clients to learn about their ability to have sex, consenting to sex, negotiating accommodations for intimacy and sex with their spouses, and counseling those who took on caregiver roles for their spouses. Social workers reported that individual diagnosis, such as dementia, should not alone determine one’s ability to consent to sex.     

Partnership,Service Needs and Assessing Competence in Post Qualifying Education and Training

Education and training must extend beyond initial qualifying courses into post qualifying professional development throughout a social worker's career if practice is to be most effective in meeting clients' needs. In the United Kingdom a Framework for Post Qualifying Education and Training was introduced from 1990. Revised frameworks have been put in place from autumn 2007 in each of the four home countries of the UK. This paper reflects on lessons learned in implementing these post qualifying frameworks in Northern Ireland. Within the overarching theme of relevance to practice, issues are drawn out under three main themes: (1) partnership working between employers and universities including the importance of leadership from policy makers and senior managers; (2) assessing competence including providing an Independent Assessment Route to increase access and to benchmark professional standards; and (3) meeting service needs including specifying learning outcomes to cover a range of practice contexts and accrediting employer-based programmes. Meeting service needs more closely is identified as a key issue driving the new Northern Ireland Post Qualifying Framework introduced in 2007.     

Launching Medical Foster Home Programs: Key Components to Growing This Alternative to Nursing Home Placement

Objective: The objective of this research was to examine and explain elements that enhanced or thwarted program growth of the United States Veterans Health Administration Medical Foster Home program. Methods: This qualitative study was conducted nationally through individual interviews over the phone and in-person (n = 22) with coordinators (n = 15 at slow-growth programs; n = 6 at fast-growth programs), program support assistants (PSAs) (n = 1 at slow-growth program), and home-based primary care team members (n = 3), as well as three in-person focus groups (n = 28 total participants) with home-based primary care team members. All participants (N = 53) were involved with programs in existence for at least two years. Results: Facilitators and barriers that enhanced or thwarted program growth emerged around four themes: A full-time coordinator; Unmitigated home-based primary care team engagement; Pursuit and receipt of appropriate referrals; and Match between caregiver, home, and Veteran. Conclusions: To facilitate program growth, program leaders should consider themes identified and how to foster situations and shape policies that put themes into practice.