‘Disability is not a word we use’: Social workers' professional judgements about support for disabled young people leaving care

Disabled young people leaving care often experience a more complex transition to adulthood than other youths. Still, policy and services can fail to recognize the intersection between a young person's care experiences and disability. Drawing on data from a qualitative interview study with 14 social workers who work with aftercare in the Norwegian child welfare services, we investigate social workers' professional judgements about support for this subgroup of the leaving care population. Our analysis uses the theoretical construct of institutional logics and shows that social workers did not include concepts of disability in their judgements about support for these young people. Instead, the social workers' considerations were guided by three other organizing principles: a ‘medical logic’, an ‘activation logic’ and an ‘aftercare logic’. We discuss these findings in light of critical disability studies and argue for a more nuanced understanding of disability in social work practice with care leavers. Highlighting disability rights and going beyond diagnosis and categorisations of disabled people can challenge a medical model approach to service provision.     

Elderly Consumers and Social Care Policy

The development of social care policy for elderly Australians is proceeding with little regard for the preferences and perspectives as expressed by the elderly themselves. The likely consequence is a continuation of policies based largely on other people's assumptions about what elderly people actually need and the extension of service categories into which many elderly people do not easily fit. Discussions with 71 elderly consumers during 1983 in Queensland established that they have input to make into policy and service delivery issues such as the provision of information on services, the determination of needs, the extension of choices between alternative services and choice of appropriate service providers. Social care policy should not continue to develop around singular and untested assumptions concerning what elderly people need and prefer.     

Exploring Social Care: Applying a New Construct to Young Carers and Grandparent Carers

Mainstream literature on paid care for children, frail elderly people and people with chronic illness or disability, and unpaid care provided usually by family members within households and kin networks tends to establish dichotomies: formal/informal, commodified/non‐commodified. Recent feminist literature rejects these dichotomies, developing models of social care in which the interconnections of paid and unpaid care are mapped within policy frameworks. This paper uses theoretical frameworks of ‘social care‘: care as labour; care as a relationship embedded in obligation; care incurring a range of costs; to explore two case‐studies: young carers aged up to 24 years who are most often caring for a co‐resident parent; and grandparents who are the primary carers of their grandchildren. The latter may occur under the aegis of child protection authorities, or Family Court orders, or in informal arrangements, not licensed by state authorities. This analysis of the international literature and Australian research data affirms the power of the social care framework, and also shows the influence of social policy settings on informal care provision.     

Transformation of Social Care Services for the Elderly in Slovakia

ABSTRACT

The main objective of this article is to present a theoretical framework for the relevant historical, economic, demographic, and political factors influencing the transformation of social care services for the elderly in Slovakia. A major restructuring of the social care services for the elderly is necessitated by the aging of the Slovak population (demographic reason), the path dependency of the current Slovak elderly care system (historical reason), the growing purchasing power of older people and the general population (economic reason), and new requirements formulated by the European Union and the general public (political reason). Historical documents, legislative acts, strategic documents, international project documents, and statistics were reviewed, and 34 open-ended interviews within the framework of two case studies were carried out in order to obtain qualitative and quantitative data. The theoretical framework and the results based on those interviews indicate that the Slovak social care service for the elderly may turn out to become more similar to the advanced Central European systems, but also that prompt legislative and financial changes are required. Nevertheless, the future direction can only be more precisely identified when more case studies can be compared with one another.     

Solidarity in Italy's policies towards the frail elderly: a value at stake

The Italian public policies towards the frail elderly are underdeveloped by both quantitative and qualitative standards. The bulk of care responsibilities lies on the family and the private provision of paid care is flourishing. The last decade was characterised by significant signs of improvement – an increase in the public resources committed to long-term care and the rising interest of politicians and scholars towards this issue – but the situation is still highly critical. In such a context several questions on solidarity arise regarding the degree to which this value is actually embedded in the public policies, what are the most relevant issues and how the main actors involved are concerned. The article aims to answer some of these questions, taking into consideration the points of view of the main actors: elderly people, carers and professionals.
In doing so, the article discusses the targets of the public services, differences in their provision across the country, the rise of the care allowance and the private provision of paid care. The article shows the problems regarding solidarity in the Italian policies towards the frail elderly and sets an agenda of issues to deal with in the next decade. How policy-makers will be able to manage these issues will determine whether and how the value of solidarity will shape Italy's long-term care policies in the future.     

A Brave New World of Personalized Care? Historical Perspectives on Social Care and Older People in England

Social care policy for older people in England continues to generate extensive discussion around the need to break with the past and to deliver a personalized response to need. This article explores the extent to which this represents a complete break with the past by looking at four key reports from the past, namely the Rucker Report (1946 ) on the break up of the Poor Law, the Seebohm Report (1968 ) on the personal social services, the Griffiths Report (1988 ) on community care and The Royal Commission on Long Term Care ( Sutherland Report, 1999 ). Each is interrogated in terms of how social care is defined, how services are to be delivered, how quality is understood and the assumptions made about who will be able to access services. This analysis is used to draw out key continuities in policy assumptions such as the primacy of family and the ongoing debate about ‘What is social care?’ and how it can be distinguished from health care. The article also argues that the voluntary sector has always been seen as a ‘key player’ in social care. Finally, the analysis of the four reports is used to trace the ever changing role of local authorities in the planning, purchase and provision of social care services for older people.     

China's ‘Socializing Social Welfare’ policy: a study on service quality in society-run homes for the aged in Beijing

This study aims to examine service quality in the emergent society-run homes (SRH) in Beijing from the perspective of residents in the context of ‘Socializing Social Welfare’ policy reform. Quantitative and qualitative research methods were combined to provide a comprehensive approach. A novel instrument for measuring service quality was developed and validated. Nine dimensions and three domains of service quality were identified and explored. The measuring instrument reveals that service quality in the SRH is barely satisfactory. With the findings of this study and the corresponding recommendations, it is hoped that the quality of institutional care service for the elderly can be improved, the social capital of the SRH can be promoted, and an integrated system of diversified care services can be formed and serve the needs of the increasing population of aged people.     

Admission to Nursing Homes in Taiwan

The population of Taiwan is facing a radical ageing process. A proportion of the growing number of people aged 65 and over is expected to need nursing home care. This research concerns the family context of decision‐making in the process of admission to a nursing home in Taiwan. Employing survey data from interviews with elderly people in nursing homes (235 interviews) and their carers/key families (265 interviews), the factors affecting their views about admission were explored. Bivariate analysis and a logistic regression model were also used to examine perceptions of alternatives to nursing home care among family members with elderly relatives in nursing homes. Most elderly people in Taiwan are cared for in their own homes by their families but, in some circumstances, entry to a nursing home seemed inevitable. This research found that the decisions were taken mainly within a family context. The adult children of the elderly people, carers/key families’ preferences and the availability of carers influenced the decision. Apart from the important need factors of elders, families’ views about alternatives to nursing homes were significantly influenced by their preferences. This study has important implications for long‐term care in Taiwan. It is hoped that this will be needs‐led, both by elderly people and their families.     

Long-term Care in China: Issues and Prospects

One of the major socioeconomic challenges China faces is the rapid aging of its population. China is now an aging society, even though it is still regarded as a middle-income economy. Coupled with the market-driven reform of social services and rapid erosion of family support, the provision of affordable and accessible social care services to older people has already become an urgent issue for the government to address. Looking into the future, the formulation of a sustainable position on long-term care (LTC) will increasingly become the major focus of social policy. This article sets out the background to the demographic shifts resulting in the emerging need for LTC in China. It analyzes the issues facing LTC services and reviews their prospects, including the structure, operation, financing, and interfacing of residential and community-based home care services.     

From Official Supervision to Self‐monitoring: Privatizing Supervision of Private Social Care Services in Finland

In October 2011, a new Act on Private Social Care Services came into force in Finland. The Act included a provision on a ‘self‐monitoring plan’. According to the provision, providers of private social care services are required to draw up a self‐monitoring plan and to follow its realization. The plan must be kept publicly on view so that clients and their relatives can also keep an eye on the realization of self‐monitoring. In this article, self‐monitoring is first explained and then briefly analyzed against the background of a wider theoretical discussion on accountability. It is argued that the introduction of client involvement in the supervision of private social care services represents a new mechanism of accountability that is typical of the Post‐Keynesian welfare state. Because public authorities are no longer able to supervise the growing number of private social care service providers, the responsibility has been partly shifted to service providers themselves as well as to clients. However, it is argued that the idea of self‐monitoring lends itself poorly to ‘delegated’ private social care services, i.e. to services that are outsourced to private service suppliers. Supervision of private social care service providers should not be too eagerly delegated to service providers themselves, or to clients, because we are here dealing with the constitutional right to adequate social care services. Client involvement also involves numerous practical problems, as shown at the end of the article.     

Towards Understanding Variations in Social Care for Older People in England

Indicators of the public provision of old age social care are routinely recorded in England and have been used for diverse purposes including performance monitoring. Despite long‐term policy guidance promoting more homogeneous service provision, large variations can still be observed between local authorities (the providers of state‐funded social care). Our aim is to better understand such variations in a small selection of key aggregate indicators. Drawing on multiple data sources and pursuing a two‐step strategy, we first assess the explanatory power of a set of structural predictors and then add to the models a set of specific care management ‘process’ predictors. We find that structural factors beyond the control of local authorities explain a considerable share of the observable variation. The additional explanatory power of care management characteristics is small in comparison. Therefore, our findings suggest that caution must be taken when aggregate indicators of service provision are used for performance monitoring purposes, as a degree of autonomy over outcomes may be implied which in light of the empirical evidence is unrealistic. Past attempts to influence the aggregate pattern of service provision – apparently seeking greater ‘territorial justice’– are likely to have had adverse implications for service users and the uniformity of service delivery across England. Questions are raised about the adequate role of central government in a policy environment characterized by longstanding local government responsibility.     

Love and money: payment, motivation and the fostering task

Although the payment of foster carers has attracted greater attention in recent writing and research, coverage of the issues has been limited. In this study, based on interviews with 20 female carers, the place of payment within foster care is explored in greater depth. The focus is on charting how carers perceive their task as ‘parenting’ or ‘job’, whether and how they experience payment as compensation or as an appropriate reward for their skills. Also examined are the ways in which payment may impact upon the practice of foster care, for example in decision making over the taking or ending of placements and the provision of aftercare support for care leavers. The study highlights the distinctive nature of foster care as an institution that straddles the public and private domains, and examines the resulting complexities. It concludes by suggesting that while payment issues provide important threads that run throughout foster care, their influence is ultimately limited by the latter's base within the family.     

A Qualitative Exploratory Study on the Service Delivery System for the New Long-Term Care Insurance System in Korea

ABSTRACT

To cope with the rapid growth in its aging population, the Korean government introduced a new social long-term care insurance (LTCI) system for elderly people beginning in July 2008. This study aims to understand how National Health Insurance Corporation (NHIC) staff and home-visiting service providers experienced and evaluated the new service delivery system. A total of 26 semistructured in-depth interviews were conducted with NHIC staff primarily responsible for the functional assessment of the elderly and the home-visiting service providers responsible for providing direct services to elderly clients. In summary, interviewees had negative experiences with the new service delivery system such as difficulties in carrying out their roles. The findings suggest that Korea's new LTCI service delivery system faces challenges and that a more active role for the Korean government, especially regarding the introduction of a proper care management system, is needed to address the issues. Future research with larger sample sizes is needed to examine and understand the issues in detail.     

Will‐making prevalence and patterns in Australia: keeping it in the family

This article provides evidence of the prevalence of wills and the principles underpinning the intended distribution of estates in Australia. Intentions around wealth transfers and the social norms that underpin them occur in the context of predicted extensive intergenerational transfers from the ageing baby boomer generation, policies of self provision and user pays for care in old age, broader views on what constitutes ‘family’, the increased importance of the not‐for‐profit sector in the delivery of services, and the related need for philanthropy. A national telephone survey conducted in 2012 with 2,405 respondents aged 18 and over shows that wills are predominantly used to distribute assets to partners and/or equally to immediate descendants. There is little evidence that will makers are recognising a wider group of relationships, obligations and entitlements outside the traditional nuclear family, or that wills are being replaced by other mechanisms of wealth transfer. Only a minority consider bequests to charities as important. These findings reflect current social norms about entitlements to ‘family’ money, a narrow view of what and who constitutes ‘family‘, limited obligation for testators to recompense individuals or organisations for care and support provided, and limited commitment to charitable organisations and civil society.     

Compulsory intergenerational family solidarity shaping choices between work and care: Perceptions of informal female carers and local policymakers in Estonia

Estonians are obliged by law to provide maintenance for family members who are unable to cope by themselves. As a result, 80% of fragile older people receive informal care. Whether this is because the carers themselves feel solidarity and choose informal caring or because they lack alternatives is the question. We applied the cultural approach for explaining the construction of compulsory family solidarity in care provision to older people through the perceptions of informal carers and policy actors. Our interest is in how filial norms framed by individual responsibilities of care provision required by law can influence (i) informal carers’ perceptions concerning their choices between work and care and (ii) impact policy actors’ perceptions concerning eldercare service provision. Analysing the empirical data produced during focus groups with female carers and interviews with policy actors, we demonstrate the triple‐fold pressure to informal caregiving as an expression of compulsory family solidarity. Key Practitioner Message: ? The article demonstrates how the national Family Law Act constitutes a compulsory requirement of family solidarity in society; ? The compulsory family solidarity norm influences local‐level policymaking and inhibits the development of formal care services for older people; ? Informal carers’ choices between work and care are shaped by their personal filial norms, familialistic policymaking, and pressure exerted by older people.     

Community service provision for the elderly under the context of competitive contracting in Guangzhou

Contracting is a prevalent trend in the delivery of public and social services around the world. International experience shows that contracting has positive and negative impacts on service provision. While local experiments on social service contracting are currently emerging in China, the implementation and effects of contracting are worthy subjects of examination. This study delves into this area by focusing on community service provision for the elderly in the context of competitive contracting. A street community which is located in Guangzhou, Guangdong Province of China serves as a case study to show the implementation of competitive contracting, the provision of community service for the elderly, and the implications of contracting for care.     

Counseling the Bereaved

This paper considers many of the theoretical and practical issues underlying the provision of bereavement counseling, and discusses (a) risk factors for bereaved people, (b) therapeutic assessment of bereaved people and planning of care, (c) provision of services aimed at diminishing risk and facilitating grief and mourning, (d) key issues of family and social support in bereavement counseling, and (e) the need for further development and coordination of services for the bereaved.     

An integrated system of engaging social workers and community volunteers in social care for the elderly: case studies in Taiwan

Integrating volunteers into social care is widely expected but rarely successful in practice. This paper discusses how the Community Care Centre Plan organising community volunteers to provide services to the elderly in Taiwan. This plan successfully integrated social workers and volunteers in a national system to offer service in local communities, showing a systemic practice of community care and a unique case of community-based and volunteer-based service. The purposes of this paper are to introduce the programme design and to understand how to integrate the mission of social workers and volunteers’ performance. The governmental policy and requirements, the role of social workers and the provision of voluntary community service which contributed to form the system were examined in this paper.     

Improving Emergency Care for the Elderly

Much has been written on the developing role for social workers in hospital emergency rooms but little has focused specifically on social work interventions with elderly emergency room patients in an urban teaching hospital. A group of fifty patients over sixty-five years of age, referred to social service for assessment and assistance with home care issues, is described. The emergency room social worker's role with these elderly patients is highlighted and three case examples are discussed. It is argued that social work interventions improve the quality of both emergency and ongoing care for this growing and often at risk population.     

老年社会工作在养老机构中的应用探讨

随着人口老化,越来越多的国家政府开始正视老龄问题。而作为社会福利服务的重要组成部分,老年社会工作更日益受到重视。我国内地老年社会工作的发展却很滞后,大多数养老机构对于老年社会工作如何介入没有一个清晰的认识。这是由于我国内地社会工作发展较晚,相关的研究和实践都不是很充分的缘故。本文以笔者的实践经历为基础,从老年社会工作在养老机构服务中的角色、相处原则与介入的模式,尝试探讨老年社会工作在养老机构中的应用。