Formal and informal helping in child welfare services: implications for management and practice

The author raises questions about whether and how informal and professional helping networks may work hand-in-hand to help children at risk of harm and families at risk of dissolution.     

It Takes a Community: Older Lesbians Meeting Social and Care Needs

Although specialized formal services are becoming more prevalent in addressing the needs of the older LGBT community, little is known about informal groups that have organized to meet the needs of this population. This article presents two case examples that depict the efforts of older lesbians to meet the social and care needs of members of their communities. The concept of psychological contracting is used to analyze these experiences, and combined with a review of the literature, practice implications for care and support for this special population are discussed.     

The impact of ideology on regulation: The case of board and care homes

Debates about regulatory efforts to monitor the delivery of health and long-term care have become commonplace in health policy. Efforts to examine the key assumptions underlying the current regulatory strategies have been limited, however. Using the board and care industry as an example, this article examines how ideology influences the regulatory strategy developed. Three ideological perspectives-a free-market approach, a market correction strategy, and a critical policy framework-are reviewed in the context of efforts to regulate board and care homes in the United States. Differences in approaches to regulating board and care are presented for each of the major perspectives.     

The use of mental health care,psychotropic drugs and social services by divorced people: does informal support matter?

This study compares the mental health care, psychotropic drugs and social service use of divorced people (re-partnered or single) with that of married people. This paper questions whether the availability of informal support facilitates or substitutes for formal care seeking. Data from the Divorce in Flanders survey of 2009–2010 are used. Logistic regression analyses are performed separately for women (N = 3450) and men (N = 3020). Greater use of mental health care, psychotropic drugs and social services by single divorced men is explained by their higher need for care, while divorced women (especially single divorced) more frequently contact a general practitioner (GP), a psychiatrist, or a psychologist, regardless of their mental health, socio-economic background and informal support. Women who have support from non-family members are more inclined to use social services and to contact a GP, while support from family members is only positively related to GP consultations. With regard to men, informal support from non-family members positively influences each type of formal care seeking. Our results suggest that non-family members (and only among women, family members as well) can provide help and advice about seeking professional mental health care and social services, but they do not have an influence on psychotropic drug use.     

Family Day Care

The child care debate of the 1970s has been caught in the crossfire of conflicting ideologies and social policy uncertainties. Family day care, a largely informal but widely used enterprise, has emerged from this debate as an indispensable component of child care arrangements. This article reviews the literature on this mode of child care. Characteristics of the unstructured nature of family day care, intended to replicate the climate of the "natural" home, are explored. The changes in this informal system, with its increasing need to conform to regulation because of public subsidies, are delineated. The turbulent history of family day care regulation, which now stimulates an interest in new regulatory strategies, is noted. Research efforts in family day care are reviewed and the conclusion is reached that the data fail to demonstrate with unequivocable clarity a reliable direction for social policy. Further research directions are recommended. For the next decade, in which child care arrangements will take on particular importance, both the public and private sectors should systematically explore this informal mode of child care and its place in a range of child care arrangements.     

Being a pretty good citizen: an analysis and monetary valuation of formal and informal voluntary work by gender and educational attainment

This paper is set in the context of macrosocial/macroeconomic theories of the organization of both paid and unpaid work. The specific topic investigated is engagement in unpaid voluntary work, an activity which is thought to be important for social cohesion, civil society and citizenship. Research on the sources of social cohesion has focused on organizational membership and voluntary organization activity. There has been little investigation of informal helping of non-resident kin, friends or acquaintances, an activity which is not measured in most social surveys but is measured in time use surveys. Previous research shows that the highly educated are more likely to engage in formal voluntary organizations and data from the UK 2000 HETUS survey confirm that the highly educated spend more time on formally organised voluntary work. However, the less qualified, particularly women, spend more time on extra-household unpaid helping activities. Since both types of voluntary work are partly dependent on available time, these findings are modelled adjusting for time allocated to paid work, study, family and personal care. The findings remain statistically significant. Drawing on work carried out by the Office for National Statistics, a monetary value is placed on both formally organized and informal voluntary work. Although the median wage rates for formal voluntary work are greater than those for informal helping, the latter is greater in frequency and duration and therefore more economically valuable from a population perspective. This finding is discussed in the light of recent debates on citizenship and gender.     

Community responsibility for the self-neglectful client

Self-neglectful clients, including the elderly, are in jeopardy, partly through their refusal to accept community services that could help them; they require protection from the community. These people are alienated and isolated, and need to be integrated into the community. Their individual rights to control their own lives, however, must be protected. It is the responsibility of the community to structure services in a way that will engage these people. A comprehensive community service program appropriate to their needs would integrate formal and informal care systems by interweaving professional services, informal assistance, and mutual aid within structures that facilitate coordination of formal care programs.     

Informal Supportive Housing for Elders:

The most effective care of teh poor, frail elderly who have no family still "happens naturally" in neighborhoods and households. Cases randomly drawn from the record of a city emergency service agency reveal a high proportion of elders receiving significant amounts of care from non-relatives: friends, neighbors, and even acquaintances. Ethnographic research (interviews and investigation) of three such cases highlights important features of informal care that can never be replaced by formal interventions. The cases reveal extraordinary capacities and strengths in informal caregivers that are sometimes, at best, overlooked by professionals and, at worst, found suspect. Suggestions are made for supporting and complementing the efforts of non-familial caregivers.     

Informal care substitution: what we don't know can hurt us

Empirical studies focusing on the relationship between formal and informal home care do little to quell the fears of policymakers that expanded access to public home care services will result in the withdrawal of informal support. A close examination of the studies designed to measure the withdrawal of informal support justifies this skepticism. Concerns about the withdrawal of informal care may hinder the introduction of more extensive home care benefits. Researchers have come some distance in trying to address this policy question. The conflicting nature of empirical findings, thus far, demonstrates that the answer depends heavily on how the question is framed, how home care is measured and over what time frame, and what sorts of analytic approaches are used to model the relationship between formal and informal community-based care. This article discusses these issues in greater detail and suggests strategies to address these problems in future research.     

Informal Care Substitution:

Empirical studies focusing on the relationships between formal and informal home care do little to quell the fears of policymakers that expanded access to public home care services will result in the withdrawal of informal support. A close examination of the studies designed to measure the withdrawal of informal support justifies this skepticism. Concerns about the withdrawal of informal care may hinder the introduction of more extensive home care benefits. Researchers have come some distance in trying to address this policy question. The conflicting nature of empirical findings, thus far, demonstrates that the answer depends heavily on how the question is framed, how home care is measured and over what time frame, and what sorts of analytic approaches are used to model the relationship between formal and informal community-based care. This article discusses these issues in greater detail and suggests strategies to address these problems in future research.     

Caregiving, ethical and informal: emerging challenges in the sociology of health and illness

The concept of care, integral to medical sociology and to the sociology of health and illness, suggests new challenges in two key areas of this field: 1) within professional socialization, an examination of socialization to ethical thinking, behavior, and identity among professional caregivers, building on the substantial literature already accumulated; 2) in the arena of hidden or informal care providers, an analysis of male and female informal providers and the productive work, other than care, done by these individuals. In both analyses, as well as in all medical sociology and sociology of health and illness, gender, race, and class require more attention. Both analytic endeavors influence the substance and the contours of the field.     

Getting by in the community: lessons from frail elders

This study explores how functionally impaired, elderly persons are able to remain in the community without home- and community- based care (HCBC) under the Medicaid program. Using HCBC administrative data, Medicare data, and survey data, we find the nonparticipants in the community appear to get by through a combination of reliance on informal care, use of Medicare home care, and going without needed services. Despite their efforts to manage their care in the community, non-participants were significantly more likely than the participants to enter a nursing home during the six months following assessment. While our analysis does not allow us to attribute the higher nursing home entry to the absence of HCBC services with certainty, the finding does raise questions about whether the elements of the HCBC program that discourage participation may save Medicaid dollars in the short-run at the expense of future Medicaid costs from more rapid nursing home entry.     

Does compassion go viral? Social media,caring, and the Fort McMurray wildfire

ABSTRACT

In May 2016, an enormous wildfire threatened the city of Fort McMurray, Alberta and forced the evacuation of all of the city’s residents. Outpourings of support teemed in from all across Canada and over the world, prompting the largest charitable response in Canadian Red Cross history. This paper examines Albertans’ response to the wildfire by exploring caring and helping behaviors as well as the role of social media in facilitating these remarkable charitable efforts. The paper uses mixed methods including an analysis of the most popular Tweets related to the wildfire and an Alberta survey collected months after the disaster. The analysis of tweets reveals that care, concern, and invitations to help were prominent in social media discourse about the wildfire. The analysis of survey data demonstrates that those who followed news about the wildfire on social media express higher overall levels of care and concern for those affected, which led to helping those impacted by the wildfire. The findings provide important insights about the role of social media in disaster relief and recovery as well as citizens’ civic engagement.     

Kitwood's thought and relational social work

Tom Kitwood is a key figure in the development of thought about dementia, but generally no references are made to his work outside of elderly care. This article argues that Kitwood's thought has much to offer to all the professional caregivers, regardless of the users’ category they are caring for, and to the broader field of professional social work. Some key themes from the writings of Kitwood are examined, namely the critique of the ‘standard paradigm’; the conception of malignant social psychology; the respect for otherness in the positive person work; the person with dementia as a resource for reciprocity processes; the new culture of dementia. For each of these issues similarities between Kitwood's approach and relational social work are identified. Relational social work considers the helping process and the well-being development as co-constructions, in which the contributions not only by the helper (or the caregiver, or the social worker), but also by the helpee (or by the care recipient, or by the user) are essential: both at the same time are helped and helpers, and both are empowered by this. This idea—of great value to all social work fields—is remarkably close to the Kitwood's thought about the dementia care.     

Reciprocities in caregiving relationships in Danish elder care

This article examines the nature of the reciprocal relationships between elderly people and both their informal caregivers and home helpers in Denmark. One of the key results concerns the importance that elderly care recipients attached to various forms of reciprocity. The two major ones were hospitality and gift giving. While informal caregivers see their caregiving as normative or as generalized reciprocity, many stressed that the elderly person's personality and their expressions of gratitude and appreciation (symbolic reciprocity) were important factors facilitating caregiving. Home helpers spoke of satisfaction in helping others, but also underlined the fact that they could see some good role models for their own old age. The results are analyzed on the backdrop of the nature of the Danish welfare system, which provided liberal pensions and benefits. This indirect reciprocity enabled elderly people to retain their ability to participate in reciprocal social relations and preserve their integrity and independence.     

Stereotypes about caregiving and lessons from the Swedish panorama of care

This article analyzes the panorama of care provision in Sweden from the informal carers' perspective. We consider informal care, publicly financed services, for-profit agencies and voluntary organizations, using a survey conducted in 2009. Most cared-for persons with minor needs living in a separate household are helped also by others, but only a tenth use public services or other providers. About half of cared-for persons with major needs living in a separate household receive care also from other informal carers as well as public services. Only 1 in 10 of them relied on no one else beyond the carer interviewed. Among intra household carers—a minority of all persons cared for—it was common that the carer was alone in his/her commitment, without any contributions from public services or others. For the large majority of informal carers it is not a solitary undertaking as the commitment is often shared with family members and others and/or public services. The results suggest that ideal types about complementarity and substitution may understate the complex interplay between informal care and the public services (and potential other providers). The findings may suggest a need for more empirical research about ‘Care Cultures’ and expose simplistic representations of welfare societies; informal care plays a major—and increasing—role also in Sweden, a country with extensive public services.     

Doing good when times are bad: volunteering behaviour in economic hard times

This paper examines how the 2008–9 recession has affected volunteering behaviours in the UK. Using a large survey dataset, we assess the recession effects on both formal volunteering and informal helping behaviours. Whilst both formal volunteering and informal helping have been in decline in the UK since 2008, the size of the decline is significantly larger for informal helping than for formal volunteering. The decline is more salient in regions that experienced a higher level of unemployment during the recession and also in socially and economically disadvantaged communities. However, we find that a growing number of people who personally experienced financial insecurity and hardship do not explain the decline. We argue that the decline has more to do with community‐level factors such as civic organizational infrastructure and cultural norms of trust and engagement than personal experiences of economic hardship.     

Discretionary Use of Involuntary Commitment by Case Managers of Mental Health Clients: A Case Study of Divergent Views

In an exploratory study, case managers held divergent views about their appropriate roles in involuntarily committing clients to psychiatric care. In light of vague organizational guidelines about appropriate use of involuntary commitment, case managers drew on professional social work values to form views about commitment. These values supported client self-determination, but did not clearly delineate ways for case managers' use of power and discretion concerning involuntary hospitalization, resulting in a range of understandings among case managers. This article provides a history of discretionary choices in the helping professions, cases illustrating divergent views about commitment among case managers and consequences for clients, and a discussion of ways this range may be narrowed in the future.     

Developing family-based care: complexities in implementing the UN Guidelines for the Alternative Care of Children

In response to immense challenges facing children in out-of-home care in all parts of the world, there is a growing international trend towards the development of family-based placements for children in out-of-home care, away from large-scale institutions. This development of family-based care within a range of care options is recommended within the international Guidelines for the Alternative Care of Children (the Guidelines), which were welcomed unanimously by the United Nations General Assembly in 2009. This paper offers an overview of these guidelines’ key principles, and considers the complexities that arise in efforts towards their implementation. Drawing on the literature, supported by research that informed Moving forward (the implementation handbook on the Guidelines) and illustrated by practice examples from across global regions, the authors examine three fundamental challenges in States’ efforts to implement the Guidelines’ ‘suitability’ principle, namely: de-institutionalising the care system; financing suitable family-based care and supporting the suitability of kinship care. The paper critically reflects on de-institutionalised systems and practices, and the cross-cultural assumptions about suitable foster and kinship care that emerge in efforts towards de-institutionalisation; it aims to spark new thinking on strategic ways in which alternative care is planned and delivered, to impact on future practice.     

The business of becoming a professional sociologist: Unpacking the informal training of graduate school

While one can be labeled a sociologist in name by fulfilling formal institutional requirements, that is only part of the necessary work involved in graduate training. What is also required is mastering the informal professional culture associated with academic sociology. In this paper, we offer practical advice about informal norms in graduate school—norms we know now that we wish we’d known then. Our reflections upon our own experiences in graduate school are guided by our common research and teaching interests in informal organizational culture. What is the potential salience of informal norms, such as particularistic relations with faculty and graduate students, ceremonial versus actual practices regarding research and teaching, and emotional labor around one’s work, for better understanding the professional socialization of graduate study in sociology? Our emphasis here is to offer advice on how to navigate the graduate school realities these norms present. We also believe that sociologists should turn a more focused eye on the profession, one in which the presence of such norms is readily acknowledged and more formally considered for the benefit of teaching graduate students.