The emotional terrain of parenting and marriage: Emotion work and marital satisfaction

This study examines how the division of labor surrounding emotion work relates to the marital satisfaction of husbands and wives. The analysis is performed on data from a random sample of couples with at least one child from a northern city in a western state (N = 96 couples). Results suggest that for both husbands and wives the emotion work received from and performed for their spouse is significantly and positively related to marital satisfaction. Results also suggest that the marital satisfaction of husbands is enhanced when they are involved in performing emotion work for children, but if their levels of emotion work for children begin to approach or exceed that of their wives then their marital satisfaction tends to decline. Implications of the study are discussed.     

A human capital approach to American Indian earnings: the effects of place of residence and migration

This study utilizes a human capital approach to examine the earning differentials between different groups of American Indian couples residing on reservations and urban areas. Specifically, the focus of this paper is the determination of whether human capital effects on earnings are stronger in urban areas relative to reservation areas, and whether or not reservation-to-urban migrants receive higher returns to their human capital endowments than the reservation non-movers. Earnings decompositions are employed to examine whether differences in human capital endowments or differences in the returns to human capital are the most important factor in explaining differences in earnings of AI couples living in these two different areas.Results indicate the American Indian couples living in urban areas do enjoy a greater return for their educational attainment. Forty-eight percent of the $11,261 household earnings gap between reservation couples and urban couples is explained by labor market differences, and 31% is explained by differences in human capital. Although living on a reservation makes it more likely an American Indian couple will change their place of residence, this study finds couples that migrate from the reservation to the urban area do not receive greater returns to their investments in human capital. Couples that migrate from the reservations to urban areas make more income than the reservation stayers primarily because of greater levels of education, work experience and other investments in human capital.     

A Child's Eye View: Dementia in Children's Literature

This paper explores accounts and understandings of dementiathat are encountered infrequently. Children’s views ofdementia are under-explored and yet children, too, must be beinginfluenced by the growing public knowledge of dementia as anamed disease, particularly of old age. The first section notesthat many children will encounter dementia among family members,their grandparents and great-grandparents in particular. Thesecond section considers fictionalized accounts of dementia.These are assuming greater exposure, not so much in the professionalwelfare domain, but as a plot or character device in contemporaryfiction. This paper combines these two areas by discussing anumber of publications written for young people where dementiais a central issue, motif or characteristic. These include dementia-relatedmaterial targeted at a children’s readership. This isfollowed by development of themes arising from analysis of threenovels written for young people, emanating from Canada, Australiaand the UK. The paper ends with a series of discussion pointsfor social-work practitioners, educationalists and voluntary-sectorsupport or self-help groups working in dementia care and inolder people’s services.     

Private and Public Displays of Affection Among Interracial and Intra‐Racial Adolescent Couples*

Objective. This article examines variation in displays of affection between interracial and intra‐racial adolescent couples. Method. Using the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of adolescents in the United States, we estimate hierarchical linear models to compare characteristics of interracial and intra‐racial relationships among white, African‐American, Hispanic, Asian American, and Native American adolescents. In our comparisons we highlight three dimensions of relationship attributes: public display, private display, and intimate physical contact. Results. Our findings suggest that interracial couples are less likely than intra‐racial couples to exhibit public and private displays of affection, but are not different from intra‐racial couples in intimate displays of affection. Conclusions. Social barriers against interracial dating still exist such that even though interracial couples are similar to intra‐racial couples in their levels of intimacy in private, they are less comfortable displaying their feelings in public.     

To Coordinate Information in Practice: Dilemmas and Strategies in Care Management for Citizens with Dementia

ABSTRACT

This qualitative study, based on 19 interviews with care managers, explores the experiences of care-managers involved in assessing the need for social services for people with dementia. The study shows that social workers, as care managers, face several dilemmas in their practice concerning people with dementia, in relation to the exchange of information and in regards to conflicting interests between different actors involved in the assessment of the need for support for people with dementia. Strategies used to handle problematic situations that arise in their work are using other sources for information (e.g., relatives and actors from other professions), persuading, and pursuing creative forms of consent. However, the study shows that dilemmas and strategies used generate other, prominently moral, dilemmas for care managers in their practice, which relate to participation and self-determination by the person with dementia. The study shed light on the problematic situation for care managers in their work to coordinate information and further the new “realities“ that they encounter as well as on how to handle these new situations. This study suggests possible ways to improve the everyday work of care managers, as well as how policies concerning social work and people with dementia can be improved.     

Children in De Facto Relationships

This paper compares the family situation of children living with de facto couples with that of children living with legally married couples and examines the attitudes of de facto couples toward having children. De facto couples with ex-nuptial children were in a less favourable socio-economic situation than either de facto couples with step children or married couples with children. Differences were also observed among de facto couples with and without ex-nuptial children and married couples in their attitudes toward having children ex-nuptially. However, de facto partners with children and married partners with children did not differ in their attitudes toward children.     

Implementation of a Community-Based Approach to Dementia Care in England: Understanding the Experiences of Staff

ABSTRACT

Given the increasing numbers of people living with dementia, it is imperative that new, practical solutions are found to the issues faced by this group of people and their families. This article draws on findings from a qualitative study that explored the implementation of a community-based project to support people living with dementia in one local area in England. This approach has different names; in the United Kingdom it is Shared Lives or adult placement, which would be most comparable to family care in Europe and adult foster care in the United States. Interviews were conducted with 14 staff connected to the Shared Lives project. Interview data were coded using the normalization process theory constructs of coherence, cognitive participation, and collective action. Supportive program factors identified were a dedicated staff member and resources, and the availability of specialist knowledge and skills. Detriments to program success included lack of understanding about the service, perceptions it was a poor fit with existing practice, and wider organizational issues that negatively affected normalization of the intervention. Suggestions for future research go beyond staff opinions, stressing the importance of using a wider range of stakeholders and incorporating measurement of outcomes for people using the service.     

Learning Experiences of Older Volunteers in a Community-based Social Program for People with Dementia

Abstract

This qualitative study aimed to explore older adults’ perspectives on volunteering in an activity-based social program for community-dwelling people with dementia called Stepping Stones. Semi-structured interviews were individually conducted with eight older adults who had volunteered in Stepping Stones. Interpretative phenomenological analysis was used to analyze interview data. Four themes related to learning experiences of older volunteers in Stepping Stones emerged. These themes include (a) self-growth and confidence in working with people with dementia; (b) understanding dementia, people with dementia, and needed support for people with dementia and their families; (c) desire not to develop dementia, while recognizing that anything can happen in old age; and (d) exercising person-centered approaches and taking on advocacy roles. Findings suggest that older volunteers gain feelings of personal growth and confidence in working with people with dementia, better understanding, and enhanced attitudes toward people with dementia through volunteering in an activity-based social program for people with dementia. Older adults will be able to fill the needs of community programs for people with dementia, while experiencing benefits from volunteering and learning in later life. Further research is needed to examine to what extent having previous dementia experiences make their experiences and learning different.     

Challenges to Successful Community-based Integrated Approach to Dementia: A Qualitative Study

The aim of this study is to identify key challenges to successful community-based integrated team approach to the management of older adults with dementia. A nationwide community-based qualitative research strategy was applied. We purposively recruited 24 health-care providers and 13 family caregivers from selected 8 prefectures among 47 prefectures. Face to face interviews were conducted from May to September 2017. Qualitative content analysis was used to analyze the qualitative data. Ten themes regarding the challenges were emerged: Ignored wishes, Family caregivers’ full responsibilities, Encouragement, Practical and easy-to-understand information, Essential skills of dementia diagnosis and assessment, Gratitude by helping others, Difference between being kind and overly-kind, Legal barrier against information sharing, Coordination between volunteers and clients, and Conflict avoidance in multidisciplinary collaboration. The findings highlight the need to provide practical and easy-to-understand information for family caregivers, educate physicians in dementia diagnosis and assessment, share personal dementia care information among health-care providers, promote platforms which aim to match dementia care volunteers with older adults with dementia and their families in need of help, and raise awareness of advance care planning among both older individuals and health-care providers.     

Staff and family attitudes to fences as a means of detaining people with dementia in residential aged care settings: The tension between physical and emotional safety

This study investigates staff and family attitudes towards the use of the fences that surround many aged care facilities in Australia, in the context of indefinite detention of people with dementia. This indefinite detention has been described in a report from an Australian Senate Inquiry as “a significant problem within the aged care context”, which “is often informal, unregulated and unlawful”. Five focus groups comprising direct care workers, family members, nurse unit managers and facility managers discussed the reasons for and their attitudes towards fences. The results show a tension between the provision of physical and emotional safety. This is to say that even while it is illegal to detain people with dementia against their will, and even while participants understood the negative impact of fences on the well‐being and emotional safety of people with dementia, they accepted and supported the presence of perimeter fences because they provided the perception that fences kept people with dementia physically safe. This has implications for redressing the balance between physical and emotional safety in policy and practice.     

The Transformative Potential of Social Work's Evolving Practice in Dementia Care

Social workers in diverse service systems throughout the United States encounter many opportunities for improving quality of life for people with dementia and their families. Yet practice with this population is unclearly defined and a core set of competencies for such practice does not yet exist. Instead, it is shaped by roles within aging and health systems. These roles are informed by a biomedical disease model of dementia. This article examines social work practice and its connection to evolving views on aging and senility throughout the 20th century. New directions for practice are recommended to improve services for individuals with dementia.     

Adults with Down Syndrome and Alzheimer's Disease

Abstract

An increasing number of people with Down syndrome are at risk of dementia resulting from Alzheimer's disease. Many reside in community group homes. When they are affected by dementia, the challenge to agencies providing group homes is how to best provide continued housing and provide effective dementia-related care management. In the general population, long term care is typically provided in nursing facilities, often in special care units (SCUs). This study evaluated select factors found in group homes and SCUs to determine which is able to provide a better quality of life for people with Down syndrome affected by dementia. Interviews, using quality of life indicators, were conducted at 20 sites, equally selected from group homes and SCUs, on the basis of their experience with people with dementia. Results indicate that group homes can provide conditions associated with better quality of life and, additionally, operate with lower staffing costs due to the non-utilization of medical staff.     

Live Discharge from Hospice and the Grief Experience of Dementia Caregivers

When an individual has dementia, family members are involved in many care transitions in their roles as caregivers. One such transition is the ‘live’ discharge from hospice services. This occurs when an individual no longer meets eligibility criteria. This can be difficult for caregivers who have been anticipating an end to understand in the context of their grief process. This qualitative study (N = 24) explored the experience of caregivers of adults with dementia, including Alzheimer’s disease, who experienced a ‘live’ discharge from hospice. Specifically, the experience of grief is examined. Results from this study highlight the complexity of caring for someone with a terminal disease and the grief experience in end-of-life care as caregivers struggle to understand the individual’s terminal prognosis as temporary. This is further complicated for caregivers who must resume caregiving responsibilities or assume a new caregiving role after experiencing a loss of hospice services. Finally, hospice social workers are well positioned to offer emotional and other concrete support to caregivers who experience a ‘live’ discharge.     

SEX AND POWER IN SAME-SEX COUPLES

The purpose of this paper is to present a part of the findings of a study of 82 homosexual couples (40 gay and 42 lesbian couples) living in three states and in city and country areas. The respondents were chosen by means of snowball sampling and the methods of data collection were semi-standardised questionnaires and interviews. The paper explores the gender identity of homosexual partners, and the power structure of the homosexual units, and examines the types of sexual relationships maintained by homosexual partners. The paper concludes that homosexual couples are diverse in their sex identity, sexual relationships and power structure, and that although in terms of power they are similar to heterosexual couples they are definitely different from them in their sexual attitudes and behaviour and in the perception of their sexual identity. The paper, finally, underlines some implications for social theory and social policy.     

Providing Care for Persons with Dementia in Rural Communities: Informal Caregivers’ Perceptions of Supports and Services

Dementia is one of the costliest and most time-consuming diseases among older persons. Although informal caregivers provide the majority of care for persons with dementia, little is known about the self-perceived need for social services of caregivers of persons with dementia within rural areas. This pilot study examined the knowledge, access and intent of the practice-oriented service model of caregivers of persons with dementia in rural communities in the Midwest U.S. After a systematic training, researchers interviewed 11 rural caregivers of persons with dementia (n = 11). Data were analyzed using thematic analysis. Although similarities with other caregivers of persons with dementia were found, important differences suggesting unique issues among these rural caregivers of persons with dementia. Many participants found strength in their community, which often served as a safety net of support. Consistent with existing literature, participants expressed financial concerns, geographic barriers and lack of dementia-specific services when using formal services. The need for more specialized formal services in rural areas to supplement existing informal care networks is discussed. Policies and services based on rural caregivers’ unique concerns and challenges and that build upon their existing care networks are recommended.     

Parenting children with autism spectrum disorders: a crucible for couple relationships

As the incidence of autism spectrum disorders (ASDs) continues to rise, there is a growing need to understand how ASDs impact family life. This qualitative study explored the ways in which parenting a child with ASD impacts marriages. Using modified grounded theory, nine couples and one wife (n= 19) were interviewed. The dominant finding that emerged is that parenting a child with ASD acts as a crucible for couple relationships, exerting extraordinary pressure on partners that forces qualitative adaptations in their relationship. Two relationship phases emerged from the analysis: tag team and deeper intimacy and commitment. The resulting theoretical model can help clinicians tailor assessment and intervention for couples who are parenting a child with ASD.     

市场化、社会转型与城市郊区农村老人的“轮养”——来自子女口述史的分析

通过对河北省保定市郊区农村的深入访谈和问卷调查，本文研究了有两个以上已婚儿子的老年夫妻去世前的生活状况。研究发现，儿子成年之后的独立门户，是这类老年夫妇“宁巢”的前提，而“空巢”又是“轮养”契约得以建立的条件。市场化、社会结构转型、儿媳妇在家庭决策中作用的增强等，使老年人失去了家庭决策权。故“轮养”在生命过程中，实际是被安排的结果，而不是老年父母自己的选择。     

Options: Racial/Ethnic Identification of Children of Intermarried Couples*

Objective. Whites of various European ethnic backgrounds usually have weak ethnic attachment and have options to identify their ethnic identity ( Waters, 1990 ). What about children born to interracially married couples? Methods. I use 1990 Census data—the last census in which only one race could be chosen—to examine how African American‐white, Latino‐white, Asian American‐white, and American Indian‐white couples identify their children's race/ethnicity. Results. Children of African American‐white couples are least likely to be identified as white, while children of Asian American‐white couples are most likely to be identified as white. Intermarried couples in which the minority spouse is male, native born, or has no white ancestry are more likely to identify their children as minorities than are those in which the minority spouse is female, foreign born, or has part white ancestry. In addition, neighborhood minority concentration increases the likelihood that biracial children are identified as minorities. Conclusion. This study shows that choices of racial and ethnic identification of multiracial children are not as optional as for whites of various European ethnic backgrounds. They are influenced by race/ethnicity of the minority parent, intermarried couples' characteristics, and neighborhood compositions.     

The transition to caregiving: the experience of family members embarking on the dementia caregiving career

Although there is an extensive literature on dementia caregiving, research on family members' adjustment to the onset of dementia and on the early stage of caregiving is limited. This article describes a phenomenological study based on twenty semi-structured interviews with spouses and adult daughters of someone with early/mild dementia or mild cognitive impairment (MCI). Participants were asked to describe the earliest changes in the parent or spouse and the changes to their everyday lives and in their relationships brought by cognitive impairment. These family members reported taking on many new responsibilities in a highly interactive caregiving process consisting primarily of decision-making and supervision. Many participants reported experiencing frustration, resentment, grief, and relational deprivation, along with increased protectiveness and tenderness towards the person with dementia. Most of the participants were ambivalent about seeking or accepting help from others and seemed to want to maintain the status quo as long as possible. Social workers meeting with families in the context of disclosure of a dementia diagnosis or the early adjustment period may help by identifying their losses, normalizing negative feelings, and helping families envision ways they could use outside help.     

Co‐producing Approaches to the Management of Dementia through Social Prescribing

A promising approach to the management of dementia is ‘social prescribing’. Social prescribing is a form of ‘co‐production’ that involves linking patients with non‐clinical activities, typically delivered by voluntary and community groups, in an effort to improve their sense of well‐being. The success of social prescribing depends upon the ability of boundary‐spanning individuals within service delivery organizations to develop referral pathways and collaborative relationships through ‘networks’. This article examines the operation of a pilot social prescribing programme in the North East of England, targeted at older people with early onset dementia and depression, at risk of social isolation. It is argued that the scheme was not sustained, in part, because the institutional logics that governed the actions of key boundary‐spanning individuals militated against the collaboration necessary to support co‐production.