Allocating Homes for People with Intellectual Disability: Needs,Mix and Choice

Allocation of housing and support services for people with intellectual disability is based on three major sets of criteria: an assessment of the applicants' needs; considerations of social mix; and the applicants' own choices. This article examines the philosophical and institutional rationales underlying each of these notions and the tensions arising when seeking to achieve a balance between them. The first section of the article is based on a review of related studies in the UK, the USA and Australia, mainly on allocation policies in mainstream social housing. The second section presents original empirical work carried out in the state of Victoria, Australia, in 2007–08, illustrating some of the implications of a new balance that was created between needs, mix and choice in allocation of housing and support for people with intellectual disability. The article argues that the concepts of needs, mix and choice should be redefined in a way which reflects the interdependencies between them. Further, the article calls for more extensive mutual learning between studies of mainstream social housing and housing for people with intellectual disability.     

The dynamic,complex and diverse living and care arrangements of young New Zealanders: implications for policy

The living arrangements of young people in New Zealand are diverse and often complex. In this article we report the range of care and living arrangements of 209 15-year-old New Zealanders, 47 of whom identified as Māori. These young people were participants in the second generation of a cohort study. Data were collected from their parents via a life history calendar and analysed for variety and consistency of care arrangements, household membership and transitions. Few participants had a consistent pattern of parental care arrangements and most had experienced multiple changes in household composition and frequent changes of address. We conclude that the whānau/family lives of many young New Zealanders are complex and dynamic. These observations contrast with the conventional notions of family life that form the basis for New Zealand’s family policies. We argue that social policies and services impacting on young people need to reflect the lived reality of young people if they are to meet young people’s needs.     

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.     

Combining generalist and specialist social work in activation policies: A participatory action research

In the last decades, activation policies and practices aimed at getting people off benefits and into work have been at the forefront of social policy. One of the challenges of activation practices is that social services with a narrow specialist focus fall short in supporting vulnerable target groups. A growing body of social work literature recognises that both generalist and specialist social works play an important role in supporting vulnerable target groups that face wicked problems. We conducted a participatory action research on how specialist social workers may adopt the principles of generalist social work in counselling and guiding people with multiple and complex needs towards the labour market.     

We're GRAND: a qualitative design and development pilot project addressing the needs and strengths of grandparents raising grandchildren

Custodial grandparents play a significant role in sustaining healthy families, but the caregiving is demanding. A social research design and development process informed a school district‐university partnership project responding to the needs of a group of custodial grandparents. Three phases of the project are described: (i) needs assessment; (ii) design and implementation of a psychoeducational group facilitated by social work faculty and a school district administrator; and (iii) evaluation of programme impact. Major themes from the needs assessment and evaluation are presented. Discussion highlights the need for school and family engagement, recognition of the significant changes in family role required for grandparents, and viewing custodial grandparents as leaders and engaged caregivers. The meaning of diversity in group intervention for this population is also explored.     

Gender Identity and Social Services: Barriers to Care

ABSTRACT

Transgender people seek social services for a variety of reasons. This literature review highlights needs assessments and social science research articles (N = 30) from the last 16 years that demonstrate the many ways in which social services are further revictimizing transgender people. Studies indicate that transgender people often encounter ignorance, hostility, and transphobic environments while attempting to access social services, and these environments can dissuade transgender people from gaining needed care. Suggestions are made to address these inequalities and include simple measures that social service agencies can begin with to make their services more transinclusive. Future research should address the bias in social services more directly and also develop a clear plan of action and best practices to help agencies remove discrimination from social service settings.     

From Interviewers to Friendly Visitors: Bridging Research and Practice to Meet the Needs of Low-Income Latino Seniors

This article describes a community-based participatory research (CBPR) effort conducted in a low-income, predominantly Latino community, which bridged traditionally-separate domains of practice and research by engaging neighborhood residents in a collaborative capacity-enhancement process for meeting the needs of vulnerable elderly residents. What began as a simple needs assessment to facilitate program development became a mechanism for engaging neighborhood residents in a collaborative social capital development process. The article describes the origins of this community-based effort, its consumer-led transformation from traditional needs assessment to service provision, resulting benefits and challenges, and implications for meeting the needs of vulnerable populations.     

From interviewers to friendly visitors: bridging research and practice to meet the needs of low-income Latino seniors

This article describes a community-based participatory research (CBPR) effort conducted in a low-income, predominantly Latino community, which bridged traditionally-separate domains of practice and research by engaging neighborhood residents in a collaborative capacity-enhancement process for meeting the needs of vulnerable elderly residents. What began as a simple needs assessment to facilitate program development became a mechanism for engaging neighborhood residents in a collaborative social capital development process. The article describes the origins of this community-based effort, its consumer-led transformation from traditional needs assessment to service provision, resulting benefits and challenges, and implications for meeting the needs of vulnerable populations.     

‘Growing Old’ in Shelters and ‘On the Street’: Experiences of Older Homeless People

Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (n = 14) and persons new to homelessness in later life (n = 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.     

Carers of People with Learning Disabilities, and their Experience of the 1995 Carers Act

Summary This paper seeks to highlight the impact of the Carers (Recognitionand Services) Act of 1995 on carers of people with learningdisabilities. It draws on research conducted in the south westbetween 1997 and 1999, which examined the views and experiencesof carers who had an assessment of their needs, together withthose of the person they care for and the professional conductingthe assessment. It concludes that the Carers Act is not widelyused, or understood, by this group of carers. Recommendationsfor improving practice include changes to the current terminology,new triggers for a carer's needs assessment, and a greater inputfrom other agencies, especially health services. Although thecurrent paper focuses on the views and experiences of carers,an exploration of the Carers Act, and its effect on potentialconflicts of interest with the person with learning disabilities,is available elsewhere (Williams and Robinson, 2001).     

Where has all the care management gone? The challenge of Parkinson's disease to the health and social care interface

Summary The delivery of health and social care has undergone massivechange in the UK in the 1990s. A key factor in the drive forreform was the failure of joint working arrangements betweenhealth and social services and the need to provide integratedcare for people who have overlapping health and social careneeds. This article draws on a research study investigatingthe community care provided to people with Parkinson's diseasein the wake of the 1990 National Health Service and CommunityCare Act. As a chronic progressive disease predominantly affectingolder people, the management of Parkinson's provides an exemplarof some of the key features of supporting people with continuingcare needs. This study found serious deficits in the assessmentand meeting of need, arising from weaknesses at the health andsocial care interface. The article concludes by consideringan approach which resources and supports the service user/carerin managing their own care pathway.     

Risk, Contingency and the Third Way: Evidence from the BHPS and Qualitative Studies

New Labour's "Third Way" in welfare derives its intellectual underpinning from "risk society" theory as developed in the UK by Anthony Giddens. The theory suggests that the crucial changes affecting citizens of modern societies are globalization, the post-traditional social order and social reflexivity. These changes lead people to question authority and to wish to take greater responsibility for meeting their needs. Applied to welfare, the analysis suggests a diminution in the role of government, greater proactivity by citizens and subsidiarity favouring community groups and also the private sector. It buttresses Third Way calls for "no rights without responsibility" and "equality of opportunity, not equality of outcome". This paper reports qualitative and quantitative research which indicates that the risks of modern social life are experienced differently by different social groups. Risk society theories assume value consensus. They understand social change to have a common impact across society, leading to a common response, and direct attention away from the particular needs and aspirations of more vulnerable groups. The risk society thesis is class ideology masquerading as social theory: it serves the interests of those already privileged in a more flexible society by obscuring the needs and aspirations of the more vulnerable, who already bear most of the burdens of social change.     

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.     

Sustainable livelihoods framework of visually impaired people

The Sustainable Livelihood Framework was applied to analyse the lives of visually disabled people with the goal of creating a Sustainable Livelihood Framework specifically suited for the daily needs of visually impaired people. Empirical evidence was drawn from semi-structured interviews with 12 visually impaired participants who were selected according to conditions of visual impairment and then with 6 visually impaired people who had professionally successful lives in Thailand’s capital Bangkok. The findings demonstrated that self-concept and societal attitude were the fundamental factors in constructing a secure and sustainable livelihood for visually disabled people. Additionally, social acceptance was an essential requirement for visually impaired people to enhance their livelihood.     

Supporting ethical use of electronic monitoring for people living with dementia: Social work’s role in assessment,decision-making,and review

Walking outdoors supports health and well-being, but some people living with dementia are at increased risk of getting lost and of harm while missing. Electronic monitoring can potentially play an important preventative role by enabling the person’s location to be continuously monitored by caregivers. However, there are considerable ethical concerns arising from electronic monitoring. This paper explores these thematically, drawing attention to its implications for autonomy and liberty; privacy; dignity; the rights and needs of caregivers and families; beneficence and nonmaleficence. Following from this, key questions for consideration in social work assessment are identified. The ethical issues necessitate assessment of the person’s unique circumstances and preferences and that of their caregivers, and careful ethical deliberation in decision-making. Social work can play an important role in facilitating inclusive assessment and decision-making, leading to consensus on intervening with electronic monitoring. The need for the ongoing review following implementation is discussed to track whether decisions need modification in light of the experience of usage. In conclusion, while legislative instruments and professional codes of ethics frame social work practice responses, there is need for a nuanced debate about ethical use of electronic monitoring and specific guidance to inform assessment, decision-making, and review.     

The Utilization of Social Services by the Mexican-American Elderly

One of the knowledge gaps in empirical research on utilization of service is that little attention has been given to testing causal models of use among the various ethnic elderly groups. The purpose of this study is to analyze the pattern of determinants of social service use among the Mexican-American elderly. A causal model of social service use was tested using a subsample of data obtained from a national needs assessment interview of 1,805 randomly selected noninstitutionalized elderly Hispanics. The findings, indicate that knowledge of social services, need for social services, perceived health status and income have direct effects on the use of social services. The major findings are discussed in relationship to past empirical research.     

Social Empathy: A Model Built on Empathy,Contextual Understanding,and Social Responsibility That Promotes Social Justice

ABSTRACT

A model of social empathy is described where social empathy is defined as the ability to more deeply understand people by perceiving or experiencing their life situations and as a result gain insight into structural inequalities and disparities. The three components of the model—individual empathy, contextual understanding, and social responsibility—are explored and explained. Social empathy provides a framework for more effective social policies that address disparities and support social and economic justice for all people. Social workers are well positioned to enhance social empathy, and application and suggestions for further enhancement and research are provided.     

Substance Use Decision-Making – Are Clinicians Using the Evidence?

Clinical assessment and treatment decision-making is a complex, everyday task for the substance use workforce. This Canadian study conducted with community substance use providers in the Interior region of British Columbia examines the factors clinicians pay attention to in their decision-making. A randomized factorial survey approach, using three unique vignettes embedded with factors of interest, was used to test the effect of case and respondent factors on assessment and treatment decisions. Responses were received from 106 participants, representing approximately a 35% response rate, yielding a sample size (n) of 308 vignettes. Multiple regression tested the independent effects of the vignette and clinician factors on assessment and treatment decisions. Factors within the vignette associated with withdrawal, physical illness and mental health issues emerged as the most predictive elements. The social complexity of people’s lives, client’s stated treatment preferences and readiness for change, and respondent characteristics were obscured in decision-making. This study indicates a lack of fidelity in the use of core assessment and treatment-matching tools, suggesting that clinician decision-making may, in everyday practice, be more heuristic and evidence-informed than evidence-based. Further research on normative decision-making practices in the substance-field is warranted.     

Professionals Assessing Clients' Needs and Eligibility for Electric Scooters in the Netherlands: Both Gatekeepers and Clients' Advocates

Independence and maintaining social contact are important factorsof elderly persons’ quality of life. An electric scootermay support people with mobility problems to achieve these goals.In the Netherlands, needs assessors have been appointed to evaluateclients’ eligibility for electric scooters. They haveto cope with a twofold job assignment: allocating services toonly those clients who are eligible according to predeterminedcriteria, but also acting in their client’s best interest,for the system of needs assessment should be client oriented.This paper examines how needs assessors apply eligibility criteriaand act in the client’s interest at the same time. A qualitativestudy was performed, observing twelve house calls of clientsrequesting an electric scooter. Interviews were held with needsassessors and a document analysis was made. We found that needsassessors used their discretionary room to create their ownpolicy regarding who deserves an electric scooter and who doesnot. They did this by concealing or emphasizing certain information.Especially when needs assessors sympathized with their clients,they did their best to sustain the case. The paper concludeswith the suggestion that needs assessors would benefit fromdiscussing their personal values, not only to agree on theirnorms as a professional group but also to avoid illegitimatearguments influence the decision. Furthermore, needs assessorshould try to influence local social policy, gearing it towardsthe needs of the local community.     

'Your friends don't understand': Invisibility and unmet need in the lives of 'young carers'

This paper is based on a study of the experiences of people identified as ‘young carers’, commissioned by the National Assembly for Wales as part of a wider review of carers’ needs and services. Following a brief review of some of the previous research in this area, the paper reports key findings of the research, using the words of children and young people as much as possible. It then goes on to explore some of the wider implications of this and other research for the identification and support of ‘young carers’ and their families, and for the understanding of the needs and wishes of children and young people so defined. The paper concludes with an alternative definition of a ‘young carer’ and with some recommendations for professional practice, suggesting that the role of social work is crucial in this area of service.