Establishing Empirically-Informed Practice With Caregivers: Findings From the CARES Program

There is increasing interest in delivering efficacious interventions to caregivers. This study reports on the processes and findings from a modified approach of the Wraparound System of Care. The practice model is implemented over 4 phases and is based on 3 theoretical constructs and 10 principles. The evaluation utilized treatment fidelity measures and employed a quasi-experimental pretest/posttest design to examine caregiver outcomes (N = 120). Findings suggest significant improvement among caregivers’ self-reported health, life satisfaction, well-being, and quality of life, as well as a reduction in caregiver risk and burden. Delineation of the processes used in the model are presented.     

Living Close to a Person With Cancer: A Review of the International Literature and Implications for Social Work Practice

To help family caregivers (FCs), social workers need to understand the complexity of FC’s experiences and challenges. For this systematic review, several relevant, multidisciplinary electronic databases were searched. Of 1,643 titles identified, 108 articles met the inclusion criteria and are included in this review. Various experiences, symptoms, and burden related to caregiving responsibilities are described and discussed. The understanding evolving from this study about the FC’s own health risk, caregiver burden, and experiences over time can enhance a social worker’s awareness of an FC’s challenging situation and the potential impact this has on the FC’s ability to provide care to the patient.     

Dementia Caregiving Outcomes: The Impact of Caregiving Onset,Cognitive Impairment and Behavioral Problems

With a projected increase in the prevalence of Alzheimer’s disease (AD) and related dementias, family caregiving is steadily increasing. Caring for an individual with AD is characterized as a “career,” and within this career are a number of key transitions, including the onset of caregiving. Research reveals a number of negative emotional health outcomes for AD caregivers, including depression and role overload, but less research has examined the influence of key transitions on the emotional adaptation of caregivers. The purpose of this study is to examine how different patterns of caregiving onset (gradual and abrupt) impact emotional health outcomes for AD caregivers. This study also explores how care-recipient cognitive impairment and behavioral problems moderate these relationships. Cross-sectional, quantitative data from 100 caregivers completing self-administered surveys were used. A series of one-way ANOVAs and multiple regression analyses were conducted to address study aims. Results indicate that care-recipient cognition and behavioral problems moderated the relationship between caregiving onset and emotional health outcomes for caregivers who experienced a more abrupt entry into the caregiving role. Results suggest the importance of considering different onset transitions and moderating factors within the caregiving career to target clinical interventions. Implications for social work practice are discussed.     

Transitions in Caregiving: Evaluating a Person-Centered Approach to Supporting Family Caregivers in the Community

Caregivers of older adults provide a wide range of informal supports and services that enable older adults to continue living in the community. This study describes the use of a multicomponent intervention combined with a person-centered approach to assist caregivers of older adults in the community. Four hundred and eighteen caregiver and care recipient dyads participated in this study and their outcomes related to burden, depression, well-being, and care recipient functional status were evaluated. The findings suggest that adult child and spousal caregivers experience burden differently. Programs designed to support caregivers must tailor services to the unique needs of adult child and spousal caregivers.     

Meeting the Needs of Male Caregivers by Increasing Access to Accountable Care Organizations

As the population of male caregivers continues to grow over time, they have become more visible to the service system. However, as the vast majority of supports serve female caregivers, it is important to bring men “inside” of the service system. Following a review of the male caregiver experience, this commentary discusses how Accountable Care Organizations (ACOs), a provision of the Patient Protection and Affordable Care Act of 2010, is one way that men can be brought into and access the service system. Although male caregivers are the focus of this paper, the recommendations suggested are useful for professionals working with all caregivers regardless of gender. Discussion includes a rationale as to why ACOs are a unique service that are currently being developed that provides a window of opportunity for health professionals to meet caregiver needs in new ways. This would include the evaluation of and addressing male caregiver psychosocial and support needs at the time of addressing care receivers’ medical needs.     

Migration Narratives: Expanding Methods to Examine the Interaction of Person and Environment Among Aging Gay Men

As they age, gay and bisexual men are embedded in multiple environments and communities. This article reanalyzes data collected as part of a larger qualitative study of crystal methamphetamine use in New York City. Focusing on the migration narratives of 30 racially/ethnically diverse men, age 40 years old and older, recruited from multiple venues several key areas emerged: ostracization, lack of affirmation as well as movement activities. Interactively they transformed social practices and increased spaces to explore sexuality, build community engagements and exchange resources. This study suggests that assessment of gay men (and other marginalized groups) may be enhanced through application of migration narratives.     

Perceptions of Caregiving Role by Son's Caring for a Parent with Alzheimer's Disease

Abstract

In this qualitative study, 18 sons were interviewed about the factors that led them to assume the role of primary caregiver for a parent with progressive memory loss, such as Alzheimer's disease, as well as the personal challenge that they experienced in this role. The analysis demonstrated that sons experience a range of emotional reactions, personal and professional conflict, as well as learn about new roles and responsibilities as they attempt to access the needed services for their parent. Clinical recommendations for geriatric social workers are discussed.     

A Conceptual Framework for Differential Use of Mediation and Family Therapy Interventions With Older Adults and Their Families

The purpose of this article is to present a family-centered approach to working with older adults. This framework utilizes a differential use of family therapy and therapeutic mediation theoretical concepts and skills. This provides an effective approach to conceptualizing and intervening with these often complex situations regarding the decision-making processes related to care of older members. Family-centered mediators/clinicians must be skilled in both models to understand and intervene in the challenging issues presented by families. A case example is included in the article to illustrate the framework.     

The Potential of Information Technology to Navigate Caregiving Systems: Perspectives from Dementia Caregivers

Technologies designed to support caregivers of adults with Alzheimer’s disease and related dementias (AD/RD) have been developing at an increasingly rapid pace. However, little remains known about caregivers’ perspectives on how technologies can and should help them navigate larger service systems they interact with to engage in caregiving. This study involved in-depth interviews and a beta test of an AD/RD caregiver app to learn more about how they currently use technologies and how potential technological features and functions can best meet their needs. Thematic findings suggest a conceptual model for designing AD/RD caregiver technologies. The findings suggest that eHealth and individual technologies may not fully meet the needs of caregivers as they navigate the larger systems within which they provide care. Findings highlight the need to develop technologies for caregivers that are effective, easy to use, and more widely disseminated – especially for caregivers from disadvantaged backgrounds.     

Inuit Elderly: A Systematic Review of Peer Reviewed Journal Articles

Over the last century, Inuit have experienced rapid social changes that have greatly impacted their way of life, health, and intergenerational traditions. Although there is a growing body of research concerning Inuit youth, relatively little is known about elderly Inuit. In an effort to bridge this knowledge gap, a systematic review of peer-reviewed journal articles was conducted. This review identified a dearth of research on older Inuit, and highlighted limitations in service provision to this primarily rural and isolated population. Implications for policy and practice and recommendations for future research are also discussed.     

Korean American Dementia Family Caregivers’ Experience of a Psychoeducational Support Group: Investigation of Role of Culture

Seven Korean American dementia family caregivers participated in a psychoeducational group. A focus group was conducted to explore the effectiveness of the group work model. Analysis of the focus group presented four themes: (1) importance of education about dementia, (2) social support from other Korean caregivers, (3) role of language and Korean culture, and (4) heterogeneity of caregivers' needs. Implications for social work practice, policy, and research are provided.     

Effects of Nurturing and Non‐nurturing Caregiving on Child Social Initiatives: An Experimental Investigation of Emotion as a Mediator of Social Behavior1

This study examined the effects of one unfamiliar adult's warm, responsive interactions or cold, aloof, unresponsive interactions on child emotion and subsequent social initiatives to a second adult. Participants were 32 4¹/₂‐ to 5¹/₂‐year‐old preschool children. Nurturing, responsive caregiving and non‐nurturing, unresponsive caregiving were experimentally manipulated by experimenter facial and vocal affective expressions, positive versus negative statements to the child, and contingency of responding to the child's behavior. The effect of nurturance was examined on child emotions and social initiatives to another adult. Non‐nurturing caregiving produced less expressed happiness and fewer subsequent social initiatives. Furthermore, child emotion was found to mediate partially the relation between nurturing caregiving and social initiatives, with children who experienced interactions with a non‐nurturing caregiver expressing less happiness, which led to decreased social initiatives to a second adult.     

Early intervention and holistic,relationship‐based practice with fathers: evidence from the work of the Family Nurse Partnership

This paper seeks to add to the literature on working with fathers by focusing on early intervention. It draws on research into fathers involved in a home visitation service delivered by the Family Nurse Partnership in England and evaluates the men's experiences of the intervention. The vulnerability of fathers was striking and many were helped to develop their practical skills and confidence in caring for their babies. The intervention was effective because of the quality time that was invested in developing relationships with fathers (as well as mothers), the focus on their strengths as well as areas for improvement and the skilled, therapeutically oriented, holistic approach through which the service was delivered. The ‘early’ nature of the help was crucial to its success because of how it so effectively tapped into the men's redefinition of themselves as caring fathers during pregnancy and following the birth. We argue that there is important learning here for social care and health services in general about how to engage men and promote fathers' capacities to care for their children.     

Mutual Aid: A Contribution to Best-Practice Social Work

This keynote speech, delivered in French and translated to English with minor adjustments for publication, presents some of the author's ideas about mutual-aid practice as best-practice social work. The author discusses the etiology and centrality of mutual aid in social work with groups, presents five characteristics of mutual-aid practice that reflect best-practice social work and identifies four key characteristics—joy in sharing, faith, courage, and curiosity—of mutual-aid practitioners. Similarities between mutual-aid practice and evidence-based group work, practice evaluation and participatory-action research are discussed as well. The author presents group work as inherently evidence based and challenges the idea that subjective measures alone may not be valid in reaching this determination.     

Couple Meaning-Making and Dementia: Challenges to the Deficit Model

By combining a relationship- and strengths-based approach, the article suggests that, with the onset of progressive cognitive impairment, verbal, nonverbal, and embodied exchanges can function as meaning-making processes for life-partner co-carers. These exchanges can sustain a sense of relatedness, which has been shown to increase wellbeing. The article identifies gaps in knowledge and practice limitations that result from the deficit approach to dementia research and care that currently dominates the field. Suggestions for future research and the development of interventions are included. In addition, the article challenges theoretical assumptions about meaning-making, arguing for a reexamination of dementia-affected couplehood processes.     

Managed care: Challenges to survival and opportunities for change

Many agree that the health care delivery system is in serious trouble. Managed care emerged in response to growing concern over spiraling health care costs without commensurate increases in population health outcomes. However, managed care needs to be evaluated within the historical context of using rationing strategies to distribute health care resources. This paper will explore the impact of managed care on social work practice, including the many challenges faced by practitioners. It will conclude with a discussion of potential opportunities for change in this volatile, health care environment.     

Importance of Research in Social Work Practice: A Pilot Study From Turkey

Abstract

It is highly important that social work practice be guided by scientific research and the resultant practices introduced to the literature. Social work research in Turkey is carried out by social work academics and practitioners. This dual position they occupy has not been thoroughly investigated in recent years; therefore, the aim of this research was to scrutinize the relationship social workers take when completing research in Turkey. Within the scope of this research, data were collected by conducting an online survey of 365 social workers. Results of the study show that 45.8% of the social workers have conducted research before. Nonetheless, 93.7% of the social work practitioners do feel the need to carry out scientific research in order to shape their professional practices. Considering these results, future research should concentrate on social work practitioners’ problems taking into account their dual position as both the producer and consumer of the research.     

Self-reflection in Reflective Practice: A Note of Caution

In reflective practice, social work students are encouragedto undergo self-reflection. It is a process of self-analysis,self-evaluation, self-dialogue and self-observation. Under appropriateconditions, social workers’ self-reflection can be veryconstructive, resulting in self-enhancement. However, underinappropriate conditions, social workers’ self-reflectionin reflective practice can be destructive and create problemsfor their professional and self-development.