Meeting the Needs of Visually Impaired People Living in Lifetime Homes

ABSTRACT

This article explores perceptions on the suitability and effectiveness of Lifetime Homes standards (LTHS) for those with visual impairment in Northern Ireland. LTHS are a series of mandatory United Kingdom public-sector housing design interventions, providing a model for ensuring accessible and adaptable homes throughout an occupant's life span. An aging demographic with increasing incidence of diabetes has led to rising numbers of elderly, visually impaired people wanting to remain in their homes for longer. Qualitative semi-structured interviews were conducted with 13 key stakeholders and thematically analyzed. Although findings show that employing LTHS offers benefits to visually impaired residents, shortcomings were also identified. Evidence indicates a need for policy makers, health-care professionals, and housing associations to modify practices to better meet the housing needs of visually impaired people. Findings may also be applicable to those with other impairments and disabilities in relation to housing for elderly residents.     

Austerity and the lives of people with learning disabilities. A thematic synthesis of current literature

Abstract

The Financial Crisis of 2008 resulted in many western economies implementing cuts in health and social care. This systematic review provides a holistic picture of the impact of austerity policy on the lives of people with learning disabilities (LD) and the collateral effects on the people who support them. Our review suggests that in the current climate of economic austerity, available funding to support people with LD is no longer aligned to their care needs. Cuts in disability services have adversely affected the well-being both of people with LD and their informal carers. Individuals with LD have lost social support and are experiencing increased social isolation. Heightened demands on family carers’ time have negatively influenced their wider roles, including parental functioning, and labour market participation. Our review provides the foundations for further discourse and research on the effects of austerity on people with LD and their family carers.     

Housing finance for the ageing Singapore population: The potential of creative housing finance schemes

A previous paper which relates to the above topic¹ briefly surveyed the current housing situation in Singapore to highlight the predicaments which beset the elderly. After a review of Home Equity Conversion Scheme (HECS) within the socioeconomic and cultural milieu of Singapore, it was concluded that the sale-leaseback scheme, if promulgated by the Singapore Housing and Development Board, could be the panacea for the housing-finance problem of the elderly.This paper continues the discussion by reviewing Creative Housing Finance Schemes (CHFS) in the light of the socio-economic and cultural parameters co-existing in Singapore. Whereas HECS seeks to resolve the housing-finance predicament of the elderly who stay put, CHFS seek to resolve the housing-finance problem for the elderly who move or want to move into a new house which is purpose-built for the elderly. The paper concludes that saleability of homes of the elderly is the main impediment to the successful implementation of both HECS and CHFS. The problem could, however, be resolved through government intervention.     

“In Their Own Voices”

Abstract

Social policy should be informed by scientific research. Yet, the rapport between researchers and policy makers remains poor, and the translation of social research into social policy haphazard. Many researchers follow a positivist paradigm and prepare quantitative reports that are difficult for policy makers to decipher. Good research is “wasted” because policy makers consider it irrelevant to the real-life problems of their constituents. Policy research that are qualitative narratives are more readerfriendly and thus more appealing to policy makers. This article argues for the inclusion of qualitative methods into research conducted to inform social policy and offers several case examples.     

Role of physical activity in the prevention of falls and their consequences in the elderly

This work aims to provide an inventory of the risk factors and consequences of falling in the elderly, namely fractures, and to identify strategies to prevent falls and minimise their effects. Falls in elderly people are a major cause of injuries, leading to a general fear of falling, poorer quality of life and even death. The increase in life expectancy brought by developments in the medical and health sciences has not always brought enhanced quality of life. More elderly people live with reduced functional capacities resulting in a higher prevalence of falls and associated problems for themselves and for society. Risk factors for falling, commonly resulting from normal aging processes, have already been identified through multiple studies. Exercise may play an important role in fall prevention and their consequences. Although, effective strategies are usually multi-disciplinary and focus simultaneously on several risk factors. However, only large-scale prevention programmes can have significant effective social impact. To minimise occurrence and consequences of falls, policies to systematically implement prevention programmes should be established.     

The Savings Approach to Financing Long-Term Care in Singapore

Summary

Singapore is grappling with provision of services for the current generation of older people at the same time as building the foundation for the coming generations of elderly. In this article, I analyze four sets of factors that are shaping long-term care policy and financing in ways that are almost unique to Singapore. First, current developments can only be understood in the context of the Central Provident Fund (CPF) that was established by the Government of Singapore in the 1950s to ensure that the working population saved for retirement; the Medisave and related schemes for financing health care were subsequently developed alongside the CPF. Most recently, the existing funding arrangements have been extended to some long-term care services, and options for further extensions are under consideration. Second, the government's philosophy of maintaining the primacy of family support for the elderly has been expressed through a number of initiatives that provide financial and other incentives to families, combined with an emphasis on community care. The third factor is the relationship between government and the voluntary welfare organizations that are the major providers of institutional and community services. Finally, a series of government-sponsored reviews and advisory councils have provided for widespread consultation on policy options. These developments are directed to achieving a multi-pillar approach in which intergenerational transfers through taxation will be limited, and the role of individual savings and insurance will be increased.     

The invisibility of age: gender and class in later life

Sociology almost entirely neglects later life. This contrasts with social policy where elderly people are largely seen as a burden on society and their carers. The article examines three areas of sociological enquiry and suggests reasons for the omission of elderly people. Parallels are drawn with sociology's earlier neglect of women. The feminist agenda has largely excluded the concerns of elderly women and at times has contributed to the pathological image of elderly people as burdens to be shouldered by their daughters. We argue that sociological theories would be enriched by incorporating the experiences of elderly people within their theoretical net.     

Chapter 6. Post-Occupancy Evaluation of a Life-Care Community for the Aged in Israel

ABSTRACT

This paper presents an advanced housing arrangement for elderly people and an innovative method of Combined Post-Occupancy Evaluation to evaluate it. The method is based on what we developed and found to be a useful checklist of housing-related needs-physical-functional and psycho-social-of elderly people. According to our findings, the fulfillment of the psycho-social needs has first priority in determining the satisfaction of the elderly with their environment. The evaluation method combines a two-fold professional evaluation and an evaluation by the users. The results of the evaluation lead to several practical recommendations, including a recommended reduction of the resources devoted to public areas in old-age homes and an increase of the investments in the individual housing units, in which most of the needs of the residents are fulfilled.     

Schizophrenia,Community Integration,and Recovery

Abstract

Rooted in deinstitutionalization policy, the community inclusion required by the Olmstead case, and the grass roots recovery movement, community integration for those who have diagnoses of serious mental illnesses has become an increasingly important policy goal. The purpose of this project was to examine empirical evidence describing experiences with social or community integration for people with psychiatric disabilities, with a particular interest in the schizophrenias. Studies chosen for review all involved direct survey or interview data from people with psychiatric disabilities and examined subjective experiences with social relationships or linked social participation with clinical, functional, or quality of life outcomes. Experiences involving the dynamics of social stigma, the achievement of personal agency, and innovative pathways to satisfying social inclusion are core themes found that are highly relevant for practitioners. Social work, with its ecological perspective, is well suited to address the complexities of conflicting interests and objectives that have arisen in mental health care in the pursuit of community integration. Suggestions for fruitful responses are presented.     

Genealogy and Ideology of Taiwan Homeless Delivery Services

Abstract

Since the mid-1990s, the number of homeless in Taiwan has been increasing. Politicians, policy makers, and service providers frequently debate whether the government should provide services for the homeless. Democracy and economic change have increased the number of homeless in Taiwan. However, the current homeless problem is also a product of a conservative welfare ideology based on family values and moral judgments. This study has implications for social workers and policy makers. (1) A universal principle for nationwide homeless delivery systems is required. (2) Restrictions that prohibit adults and youths with families providing little support from entering shelters should be eliminated. (3) Employment consultation and housing compensation should be provided to assist street people in re-entering mainstream society. (4) Supportive relationships with mainstream- based outreach services should be developed.     

Rural poverty

Abstract

This paper examines rural poverty indicators arguing that governments have failed to provide the equitable access to resources needed to empower rural people to address their poverty. The paper illustrates how the decline in the fortunes of agriculture has led to a rapid disintegration of rural communities and to human rights concerns in relation to rural people. On quality of life indicators such as health and education, rural people are seriously disad-vantaged by comparison with urban Australians. Yet, the failure of governments to develop integrated rural policy frameworks that deliver equitable resources and their reliance on market forces is leading to the destruction of rural communities. For social workers, the challenge is to provide advocacy and policy leadership.     

How Academic Research Shapes Labor and Social Policy

How academic research affects labor and social policy is viewed through a program evaluation framework that highlights the difficulties of determining the causal impact of such research on public policy. The effect is illustrated by examples. My conclusion is that academic research can have a modest to substantial impact on policy. Its impact is enhanced if it has a number of key characteristics: high quality; reputable researchers involved; synthesized and translated into a language understood by policy makers, the general public, and the media; credible champions who will broker and defend it, in the political process or in the public realm; timeliness; and, political acceptability.     

Making choices in my life: Listening to the ideas and experiences of young people in the UK who communicate non-verbally

Service user participation and making choices are frequently advocated, however, they are complex concepts and how they are translated and/or experienced in everyday life can vary amongst different groups of service users. Recognising the importance of participation in current international guidance and UK government policy this paper seeks to explore how research can include a frequently marginalised group of disabled young people, in particular young people with learning disabilities and/or who communicate non-verbally. The paper discusses the use of non-traditional research methods, especially symbol based interviews developed in an ongoing English longitudinal study exploring choices and decision-making processes for young people with life-limiting conditions. The paper then presents some research findings and concludes by discussing their implications. In particular, it demonstrates how the use of symbol based interviews can inform policy makers about how these young people can be included in research and that listening to them can inform our understanding of decision-making processes.     

Mental health of the oldest-old

As more individuals live past age 100, it is important for health professionals to better understand characteristics important to the mental health of the oldest-old in our society. Few studies have been conducted on mental health in this group, but current literature suggests these individuals are very resilient with respect to mental health and life satisfaction, despite their health disadvantages. In interviews in a variety of studies, participants talked of the importance of both inner and outer resources for empowerment. Greater understanding of mental health in aging can inform policy makers as they draft new legislation and programs to enhance quality of life for the oldest-old.     

Family support in late life: A review of the literature on aging,disability, and family caregiving

ABSTRACT

For older adults and people with disabilities in the United States, family caregiving is an important part of remaining at home and in the community. As care recipients and caregivers age, family dynamics change, and the health, social, and financial impacts of this (largely unremunerated) work have implications for individuals, families, and social policy. In this review, the authors map the literature across multiple fields related to disability and aging to understand caregiving in late life, what it means to be an older caregiver and/or to care for older people. The authors summarize the findings of 97 articles to address the care, services, and supports family caregivers provide for older adults; negative and positive impacts for caregivers serving in this role; supports that family members use or need; and societal impact of family caregiving. Much of the literature describes the work family caregivers provide and negative impacts of caregiving. Less attention is devoted to caregiving benefits, supports used by family caregivers, and societal impacts. The authors conclude with an agenda for future research that attends to the need for research that includes: more diverse samples, new types of caregivers, longitudinal data, qualitative data and analysis, and comparative research.     

Good personal finances or a strong social capital—on different life conditions of importance for an active life when becoming alone in old age

Becoming alone in old age can be a decisive life event that brings major changes depending on various causes as health status, financial resources, family situation, and available welfare services. This article discusses the situation of older people in Sweden who have transitioned from a two-person to single-person household in recent years and what impact this might have on their everyday lives. Through in-depth interviews with 18 older people, age 67–90, their experiences about life conditions and opportunities were examined. Findings showed large differences between the men and women. They all tried to live as they always had done and they used the same personal life strategies that they always had. But the men could live as before on their own financial merits, while the women needed assistance from children, grandchildren and the welfare system. Transportation options were central and clearly related to both private economy and social services available. Shortcomings in the welfare state's way of caring for the elderly were clearly uncovered. The gap between social policy promises of opportunities for autonomy and independence to live an active life in old age and the everyday reality for older people still seems to be wide.     

Evaluating Potential Environmental Variables and Active Aging in Older Adults for Age-Friendly Neighborhoods in Malaysia

As Malaysia's population is aging rapidly, and since there is no specific housing policy for the elderly, it is vital that neighborhoods meet the different needs of elderly for active aging to maintain their quality of life. This study aims to investigate the neighborhood environmental variables, the outcome active aging, and potential variables that inhibit active aging in the elderly that lead to their quality of life. It examined quality-of-life determinants that are influenced by the existence of certain neighborhood characteristics. In the study, 385 older adults aged 60+ years residing in two different cities in Malaysia were surveyed. Multiple regression was used to explore how much variance in active aging variables the neighborhood environmental factors explained as a group. The results showed that permeability, accessibility, and facilitators to walking are key determinants of active aging. There is a need to improve the physical design of the neighborhoods with regard to these three factors.     

Family Support for the Elderly in Korea

Abstract

This article discusses major issues and concerns regarding family support for parents and elderly people in industrialized and urbanized Korea. It summarizes new trends in family support for elderly members, continuing influences of the traditional value of family support (filial piety), growing needs for public services for elderly people and their families, urgent calls for the state to assume greater responsibilities for providing social security and services for the elderly, needs for cross-cultural studies of family support, and certain cultural similarities and differences to be considered. The article concludes with some suggestions for future research.     

Live to 70 Years and Older or Suffer in Silence: Understanding Health Insurance Status Among the Elderly Under the NHIS in Ghana

Ghana has introduced a National Health Insurance Scheme (NHIS). Embedded in the NHIS is a policy to exempt poor and vulnerable groups from premiums and user fees. There has been some debate as to why the start-off age for exemption among the elderly is 70 years. Ghana has a shorter life expectancy than middle- and high-income countries and its current age of retirement is 60 years. This study explores the financial and social implications of continuing to charge premiums to people aged 60 to 69 years. Based on the analysis of data from a representative household survey, it is recommended that the exemption policy should be expanded to include all vulnerable elderly persons, regardless of age.     

The savings approach to financing long-term care in Singapore

Singapore is grappling with provision of services for the current generation of older people at the same time as building the foundation for the coming generations of elderly. In this article, I analyze four sets of factors that are shaping long-term care policy and financing in ways that are almost unique to Singapore. First, current developments can only be understood in the context of the Central Provident Fund (CPF) that was established by the Government of Singapore in the 1950s to ensure that the working population saved for retirement; the Medisave and related schemes for financing health care were subsequently developed alongside the CPF. Most recently, the existing funding arrangements have been extended to some long-term care services, and options for further extensions are under consideration. Second, the government's philosophy of maintaining the primacy of family support for the elderly has been expressed through a number of initiatives that provide financial and other incentives to families, combined with an emphasis on community care. The third factor is the relationship between government and the voluntary welfare organizations that are the major providers of institutional and community services. Finally, a series of government-sponsored reviews and advisory councils have provided for widespread consultation on policy options. These developments are directed to achieving a multi-pillar approach in which intergenerational transfers through taxation will be limited, and the role of individual savings and insurance will be increased.