Dependency and its Relationship to the Assessment of Care Needs of Elderly People

Correspondence to Dr Ian Gibbs, Social Policy Research Unit, Department of Social Policy and Social Work, University of York, Heslington, York, YO1 5DD Summary A number of previous studies of old people in residential homeshave suggested that a substantial minority are not in need ofthat form of care. The rapid growth in the number of peoplein private homes, supported by social security payments andentering without any independent assessment, has led to concernthat many more people enter residential homes without needingto be there. Social workers were employed in four areas to assess the needsof residents newly admitted to homes in the independent sectorand over eighty per cent were found to be in need of residentialcare. It is suggested that the measures of dependency used toindicate need in some previous studies fail to take into accountthe complex factors involved in deciding whether a person needsresidential care.     

Professionals' attitudes to children's participation in decision-making: dichotomous accounts and doctrinal contests

The attitude of professionals to the involvement of children in decision-making is unclear. This paper discusses a recent research study that utilized qualitative and quantitative methods to explore the views of professionals working in family support and child protection about two different aspects of children's participation in decision-making: the age at which children should make decisions and whether or not they should be involved in child protection conferences. The results showed that social workers tended to favour one of two diametrically opposed viewpoints about the age at which young people should make decisions and then in discussions with colleagues they sought to persuade others to change their perspective. Social workers who believed that young people should not make decisions until much older nevertheless thought that they should be involved in conferences whereas non-social workers did not make this distinction: for them, children who were not old enough to make decisions for themselves should not be involved in conferences. The results are discussed in the light of some of the implications for practice. The paper concludes by outlining how the results informed the design of a training pack commissioned by the Department of Health concerning the involvement of young people.     

Expanding social health protection in Cambodia: An assessment of the current coverage potential and gaps,and social equity considerations

The Royal Government of Cambodia recently launched its National Social Protection Policy framework to strengthen and expand social security and assistance. To inform social health protection policy, we examine socio-economic survey data and administrative coverage data to assess the coverage potential of existing coverage mechanisms and current gaps; and compare equitable contribution rates. Over 53 per cent of the population currently has no social health protection coverage mechanism, and about 16 per cent of the population who do have access to a mechanism are not yet enrolled. Current expansion efforts focus on the formal employee scheme, primarily benefiting individuals from higher income households. In addition, recent coverage expansion to some informal workers leaves significant gaps, particularly among the informal sector. We find out-of-pocket health care expenditure to be an excessive share of income among lower wealth quintile individuals and conclude they are financially vulnerable. Finally, we illustrate that an equitable approach to individual, monthly health care contributions among the lower three quintiles has a severely limited potential for revenue generation, and collection costs could exceed the amount collected. Therefore, we recommend that vulnerable groups should be exempted from contribution payments as social health protection is expanded.     

Family planning: humanism and science

The author used to believe that social workers had built in resistances to suggesting family planning for clients. Today, however, this is not longer so because of the 1967 resolution on the National Association of Social Workers. There is however, serious concern about furnishing contraceptives or family planning information to the unmarried minor. The author contents that physicians and social workers both have to help youth in the confused area of premarital sexual relations. The abortion problem should involve the same professions. The author argues that a) every woman over 40 should have the right to make up her mind about being pregnant and continuing so, and b) every girl of 17 or less should be allowed an abortion if she is pregnant out of wedlock.     

Climate change in Alaska: Social workers’ attitudes,beliefs, and experiences

The average temperature in Alaska and the North American Arctic has risen at twice the rate of the global average due to climate change, causing changes to the natural environment that affect the physical, social, and emotional well‐being of people and communities. Social workers must be prepared to respond. Using a non‐probability, convenience sample, this study surveyed 159 social workers in Alaska to assess their attitudes and their perceptions of the effects of climate change on their clients and constituents. Results indicate that social workers in Alaska believe that climate change is happening, that human activities are responsible, and that it is a large threat to people in Alaska. Over 75% believe that climate change is dangerous for their clients now or will be dangerous in 10 years. Social workers report that in the past year their clients or constituents have experienced multiple climate change‐related problems with community infrastructure, health, and mental health.     

Moral distress among social workers: The role of insufficient resources

The present study examined moral distress among Finnish social workers and the role of perceived resource insufficiencies in explaining it. The aim was to shed light on this understudied phenomenon in the field of social welfare. The study focused on work‐related moral distress, defined as impaired wellbeing that is connected to the continual inability to implement actions that one considers morally appropriate. The survey data were collected with an electronic questionnaire between the years 2011 and 2012. The respondents (n = 817) were social workers in the public social welfare services and the overall response rate was 46.5 per cent. Nearly 11 per cent of the respondents reported experiencing moral distress and perceived resource insufficiencies strongly explained this experience. Moreover, social workers with moral distress reported that they were less willing to continue in their post, were more frequently on sick leave and had positive work‐related experiences less often than their colleagues who did not experience moral distress. Key Practitioner Message: ● The concept of moral distress is useful in describing the experiences of social welfare workers when they are unable to practise their profession according to their moral code and the emotional burden related to this inability; ● Perceived resource insufficiencies are strongly associated with experiences of moral distress among frontline social workers; ● Social workers experiencing moral distress are less willing to continue in their work, take sick leave more often and less frequently have positive experiences related to their work.     

Working in Partnership in Child Protection: The Conflicts

Correspondence to Dr Margaret Bell, Department of Social Policy and Social Work, University of York, York, UK. Summary This article critically examines the work of twenty-two localauthority social workers undertaking child protection investigations.The findings suggest that, while the social workers were committedto being (and believed their practice to be) participative,the dual tasks of making risk assessments for the conferenceand working in partnership with the families concerned producedconflicts of interests and rights. The impact of these on socialworkers' engagement with family members, on their assessments,and on the decision making process is explored. It is concludedthat the difficulties identified limit opportunities for participativepractice, and that these difficulties are endemic to the presentsystem. It is argued that these findings point up the need fora more broadly based child-care service which more appropriatelymeets the families' welfare needs, and that the contradictorynature of the conference task should be addressed by clarifyingthe legal base of the intervention and developing other modelsof decision making. Some ways forward are suggested.     

三点一线:东湖社工给力社会服务

2009年,江西省南昌市东湖区被确定为全国第二批人才队伍建设试点城区,两年来,东湖区从实际出发,进行了本土社会工作的探索和创新.东湖区位于南昌市的中心城区,同时也是一个老城区,社会转型烙印深刻,辖区人口老龄化严     

Avoidable and Unavoidable Mistakes in Child Protection Work

Summary This article argues that social workers and the general publicneed a clear understanding of the distinction between avoidableand unavoidable mistakes in child protection work. The publicis understandably distressed when a child dies and is rightto demand an inquiry to check the quality of help provided.But a child's death is not proof that any professional was incompetent.Our limited knowledge and the complexity of assessing risk meanthat professionals can only make the best judgement on the availableevidence. Analysis of forty-five inquiry reports shows thatinquiries appreciate this; in 42 per cent of them social workerswere not criticized. The analysis however also reveals one persistenterror: social workers are slow to revise their judgements. Psychologyresearch indicates that this error is widespread and by no meanspeculiar to social workers but it means that misjudgements aboutclients that may have been unavoidable on the limited knowledgeavailable when they were made continue to be accepted despitea growing body of evidence against them. Social workers needa greater acceptance of their fallibility and a willingnessto consider that their judgements and decisions are wrong. Tochange your mind in the light of new information is a sign ofgood practice, a sign of strength not weakness.     

Distress among Children whose Separated or Divorced Parents cannot Agree Arrangements for Them

Correspondence to Ann Buchanan, Department of Social Policy and Social Work, University of Oxford, Barnett House, Wellington Square, Oxford OX1 2ER, UK. E-mail: ann.buchanan{at}socres.ox.ac.uk Summary This paper, based on a larger study of children and their parentswho were subjects of a welfare report for the court followingparental separation and divorce, highlights the very high levelsof distress amongst the children involved. As measured by theStrength and Difficulties Questionnaire (SDQ), 52 per cent ofboys and 48 per cent of girls had significant adjustment problemsimmediately after the proceedings and a year later, 62 per centof boys and 32 per cent of girls were still maladjusted. Childrenwere more likely to have problems where parents were also distressedand where there was domestic violence. These findings suggestthat these children should be considered ‘children inneed’ under the 1989 Children Act. and that preventiveservices need to be developed to help parents resolve the arrangementsfor the children without going to court.     

Attitudes towards adoption disclosure in Singapore

Using data from the general public and social workers' attitudes towards adoption, the study examined adoption disclosure to the child, as well as perceptions towards social disclosure. The results indicated that the majority of Singaporeans believe that the adoptee should be made aware of their adoption status; however there is a widespread negative attitude towards disclosure to community. Age, marital status, ethnicity and familiarity with child adoption were significantly related to adoption disclosure. Social workers also shared similar perceptions towards social nondisclosure. These findings highlight the need for educational programs to sensitize the public to adoption of children in Singapore.     

The Legal System and Alzheimer’s Disease: Social Workers and Lawyers’ Perceptions and Experiences

The expected increase in the number of people living with Alzheimer’s disease (AD) worldwide will be accompanied by an increase in the number of cases involving persons with AD brought up to the courts. This study examined the perceptions and experiences of social workers and lawyers regarding these cases. Three focus groups including social workers and lawyers (n = 26) were conducted. Two main themes were raised by the participants: (a) the role of social workers and lawyers in court cases regarding AD, and (b) the need for improving legal encounters involving persons with AD. Similarities and differences were found in both professionals’ interpretations of these shared themes. Results of this study emphasize the need for increasing the knowledge and interprofessional training provided to social workers and lawyers involved in legal cases dealing with issues involving persons with Alzheimer’s disease.     

Religion and Spirituality in Social Work Education and Direct Practice at the Millennium: A Survey of UK Social Workers

Correspondence to Dr Leola Furman, 1201 Yale Place, Minneapolis, Minnesota, 55403, USA. E-mail: furmanlfurman{at}aol.com Summary In recent years, an expanding body of social work publicationsand professional conference presentations has materialized inthe United States due to a resurgence of interest in spiritualityand religion. In order to explore the level of interest in theUnited Kingdom, a random sample of 5,500 practising social workersfrom the British Association of Social Workers (BASW) membershipwere mailed a questionnaire that examined religious and spiritualbeliefs, practices and affiliations. A total of 789 BASW membersin direct practice from England, Scotland Wales, and NorthernIreland returned questionnaires, a response rate of 20 per cent.The majority of respondents believed that spirituality was afundamental aspect of being human. More than three-quartersof the sample reported little or no content on religion andspirituality in their training programme. Respondents stronglyapproved of raising the topic of religion and spirituality withclients who are experiencing terminal illness or bereavement.This also held true in matters of adoption and foster parenting.Approximately 47 per cent of all respondents believed that includingreligion and spirituality in direct practice was compatiblewith social work’s mission. This sample may representthose social workers with a stronger interest in religion andspirituality than a random sample of the general populationof UK social workers. These findings, nevertheless, raise concernabout the availability of practice models and training curriculafor social work practitioners and students.     

Making Judgements about parenting: The Example of Freeing for Adoption

Correspondence to Malcolm Hill, Senior Lecturer in Social work, University of Glasgow Department of Socail Administration and Soical work, Lilybank House, Bute Gardens, Glasgow G12 8RT. Summary Social workers frequently are involved in assessments aboutparenting. Thes issues are posed in a particularly Sharp formjudgements need to be made which may transfer parental rightsand reponsiblities permanently, as in cases of freeing for adoption.This article draws on a wider evaluation of freeing to identifythe key dimensions of parent child relations which influencedsocial work and work court decisions. In the majority of cases, there were requests to dispense withbirth parents' agreement to adoption. The principal corcumstanceswhich seen to warrant this involved inital neglect and/or poorbonding following by failure to respond to social work helpafter childern were in care. In most instances, the Courts endorsedthe local authorities position and granted freeing order. However,serveral judgments were in parents' favour. This was relatedsometimes to different perspectives on the relationship betweenfamily circumstances and the precise legal grounds for freeing.Also the lengthy precedures involved menat that in a few instancesthe parents had apperaed to imporve thier situation and so strengthenedthe legal case against freeing.     

Euthanasia and the medical profession: an Australian study

Advances in medical knowledge and technology are enabling more people to live longer in modern societies. This situation has also created dilemmas for medical practitioners in treating severely or chronically ill patients where the harm caused to them by treatment appears to outweigh the benefits. After reviewing some of the major legal and ethical issues confronting medical practitioners in Australia, this paper reports findings of a survey of Australian doctors' attitudes towards euthanasia. The findings show that a significant number of doctors receive requests from either the patients or their families to hasten death through active or passive euthanasia. A large majority of them also regard some form of passive euthanasia as an acceptable medical decision concerning the end of life. Twenty per cent of general practitioners and 17 per cent of specialists surveyed have taken active steps in the past to hasten the death of a patient. This paper explores the circumstances in which doctors are prepared to perform euthanasia and concludes with a discussion of the legal, ethical and professional issues raised by the survey's findings.     

Mixed ethnicity, identity and adoption: research, policy and practice

Mixed ethnicity children are over-represented in the care system and constitute a significant group of those seeking adoption placements. Social workers are presented with a specific set of concerns in seeking to find adoption placements for mixed ethnicity children as they come from two or more cultural backgrounds. Practitioners face uncertain principles concerning how to respond to these issues, especially in light of social and political pressures, and within the realm of existing debates around 'transracial' adoption. There is a danger that among these uncertainties the individuality of the child will be lost as his or her identity needs become viewed narrowly. Social workers may seek to simplify and classify the identities of mixed ethnicity children in the adoption process through pressures that they feel to find 'matched' placements. This paper explores how theories concerning identity can provide some insight into the difficulties practitioners face and may help to inform social work practice in this area.     

Professional Identity,Job Satisfaction,and Retention of Licensed Social Workers in Korea

This paper reports the results from a survey of 735 social workers in South Korea on their professional identity as a social worker, job satisfaction, and intention to leave the profession. The overall result shows that there was a high level of job satisfaction. Social workers' intention to leave the profession was significantly related to their integrated feelings of professional identity. This relationship was partially mediated by job satisfaction. Social workers' sense of professional identity can be tapped to help social workers feel adequate to carry out their professional responsibility. Boundaries of their practice should be well defined.     

"Never right, never wrong": child welfare and social work in England and Sweden

When are parents “unfit” to care for their own children? As in many other countries, social workers in England and Sweden have the unenviable task of forming such judgments. On behalf of society at large, social workers must balance the rights of parents to provide continuing care with the responsibilities of the state in ensuring adequate care of children. They are involved in professional judgments which are also inherently political. In both England and Sweden social workers are able to seek legal orders which, if granted, permit compulsory removal of children against the wishes of parents. In such cases social workers are centrally involved in processes which remove ordinary rights of citizenship from their fellow members of society. The rights of parents and children, together with the responsibilities of the state to each class of citizen, are clearly in focus: intervention in family life requires both grounds and legitimation. But what is the basis of intervention in the two societies? Social work practices in Sweden and England suggest very different answers to this question. In explaining these differences it is necessary to address much broader variations of social and political culture in the two societies. In so doing, variations in social work practice can be located in different cultural values and systems of legitimation. Instabilities and pathologies of professional practices can also be identified within both England and Sweden. These too are quite different in the two societies.     

Why Are They Leaving? Factors Affecting Intention to Leave among Social Workers in Child Welfare

This article addresses a topic that has not previously beenresearched in Sweden, i.e. factors associated with the intentionof social workers to leave their place of work. A comprehensivequestionnaire was distributed to 309 social workers in childwelfare in the County of Stockholm (drop-out rate: 3 per cent).The study comprised a total of forty-two workgroups. All thesocial workers handling referrals and investigating the situationof children and youth in these areas were included. One of themost striking results was that although 54 per cent of the socialworkers had been at their current workplace for two years orless, 48 per cent intended to leave their jobs. A logistic regressionanalysis showed that the variable of greatest importance forthe intention to leave the workplace was lack of human resourceorientation within the organization, i.e. the extent to whichpersonnel are rewarded for a job well done, feel well takencare of and where management is interested in their health andwell-being. A final conclusion of this study is that when measuringthe impact of different aspects of work tasks compared withsome aspects of organizational culture, it becomes clear thatthe latter seem to be most important in this respect.