Home Care

The utility of examining the effectiveness of home care is illustrated by selected examples and applications. The growth rate of home care over the past decade, regarding the possibly substantial differenccs between the quality of home care in rural and urban America, and empirical evidence that suggests inferior quality of home care for health maintenance organization patients support the need for measuring and monitoring outcomes of home care. The conclusions of a research program targeted at developing a system of outcome measures for home care, and the resulting national demonstration program to implement and refine that system, are summarized.     

Long-Term Care

This study examines the redistributive effects of public pensions on old-age income inequality, testing whether public pensions function as the “great equalizer.” Unlike the well-known alleviating effect of public pensions on old-age poverty, the effects of public pensions on old-age income inequality more generally have been less examined, particularly outside Western countries. Using repeated cross-sectional data of elderly Koreans between 1998 and 2010, we applied Gini coefficient decomposition to measure the impact of various income sources on old-age inequality, particularly focusing on public pensions. Our findings show that, contrary to expectations, public pension benefits have inequality-intensifying effects on old-age income in Korea, even countervailing the alleviating effects of public assistance. This rather surprising result is due to the specific institutional context of the Korean public pension system and suggests that the “structuring” of welfare policies could be as important as their expansion for the elderly, particularly for developing welfare states.     

Administrators and Quality of Care in Long-Term Care Facilities

This exploratory study investigated administrator and facility-related predictors of quality of care in long-term care facilities. Quality was measured using several unmet standards of care identified in the last inspection report of the Ontario Ministry of Health and Long-Term Care (2007). Supplemental data were gathered from surveys mailed to all 602 long-term care administrators in Ontario, Canada, 302 of whom completed the questionnaire. Multiple regression analyses were conducted to test sets of hypotheses linking characteristics of administrators and those of the long-term care facility to quality of care. Education and experience as an administrator in a participant's current position had a moderate positive influence on quality of care; however, negative associations were found between administrator salary and effort devoted to resident care problems and quality of care. In addition, smaller facilities, being located in less populated communities, and administrators with a nursing background significantly affected quality of care in a positive manner.     

Conversations of Care: A Narrative Review of Collaborative Care Systems for Foster and Kinship Care

This paper reviews the literature on human relational factors and their impact on complex care systems for a highly vulnerable population of children and young people in out‐of‐home care (OOHC). Factors contributing to the functioning of collaborative OOHC systems are reviewed from theoretical and contextual perspectives. The authors posit that secondary traumatic stress and vicarious trauma are central to understanding the impact of relational trauma and the experience of individuals, families, teams, and the wider ecology of collaborative care systems. Given the challenges of working collaboratively across interpersonal, family, and systems boundaries to support traumatised children in OOHC, further research is required.     

Continuing/Life Care Facilities and the Continuum of Care

The proliferation of continuing/life care facilities in the United States in recent years holds the promise of providing retirees with a full continuum of care. This survey of continuing/life care facilities in the state of Florida was undertaken to ascertain if they indeed were providing the services necessary to fulfill this promise. The results indicate that only a small percentage of continuing/life care facilities offer all the services the authors believe necessary for a full continuum of care, with shelter care being the least frequently offered service.     

Women's Health Care

No abstract available for this article.     

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.     

Learning to Care

Practice simulation exercises involve interaction with people who portray standardized clients in typical social work practice contexts. They are followed by feedback from these “clients” and from peers and instructors. This article delineates the conceptual background and previous use of this educational methodology and illustrates its application within a graduate health social work practice class. A preliminary evaluation found enthusiastic endorsement of this approach among students, with very strong agreement that all three components of the project-interaction with simulated clients, receipt of feedback, and participation as observers-prove useful. Practice simulations can allow transformative learning for participants and provide a useful classroom method for incorporating conceptual foundations into practice behaviors.     

Global Care Chains

This article critically examines the utility of the ‘global care chain’ concept and considers various modifications required to that concept in order to render it a major generative force in feminist and non-feminist research. By way of progressing this research agenda, the discussion critically evaluates the possibilities and limitations of a more rigorous application of global commodity chain analysis, from which the global care chain concept is presently only loosely derived, to transnational care

services. The incompatibility of (non-feminist) commodity chain analysis and (feminist) care chain analysis, together with the weaknesses in each of these bodies of analysis, requires the integration of a range of modifications into a revised global care chain framework. These modifications involve foregrounding transnational labour networks

and applying an engendered global commodity chain perspective to the analysis of these networks as well as broadening the application of the global care chain concept to embrace a variety of groups and settings. Further research required to progress the development of this field of study is outlined.     

Ready or Not: Transitioning from Institutional Care to Community Care

Federal legislation has moved toward the support and expansion of home- and community-based alternatives to nursing home placement. Despite the seemingly positive nature of these efforts, the question remains as to whether individuals, families, and communities are prepared for this shift in long-term care. Furthermore, there has been a lack of attention to the impact of nursing home transition programs on family caregivers, community resources, and the availability of appropriate housing alternatives. Although nursing home transition programs offer a promising alternative to institutional care, the authors suggest a closer examination of the policies and practicality of these transitions is needed.     

Scandalous Care: Interpreting Public Enquiry Reports of Scandals in Residential Care

ABSTRACT

This article reviews an earlier study written for the Wagner Committee (1988) on scandals in residential care. That review was based on a study of ten enquiry reports, only two of which were about homes for older people. The main events that were described are grouped as: institutionalised practices, indifference and neglect, physical cruelty, humiliation, too authoritarian a life-style, a dull and depressing life-style, an overcrowded and run down environment, disharmony amongst the staff team, and staff misappropriating goods or money. Now, more weight should be given to: residents' abuse of residents and of staff, an improper influence on the life-style of others, and sexual abuse. Explanations proposed are: structural, environmental, and individual and worker style. Abuse is considered in the context of the nature of direct care and the acts of intimate caring of others.     

推行子女照护责任货币化,促进老年照护社会化

随着我国人口老龄化和高龄化速度加快,在完善社会养老保险制度的同时,迫切需要进行制度创新,从我国实际出发着力发展居家养老,开拓居家养老服务所需的资金来源,促进居家养老服务的可持续发展。     

Handle with Care: Self-esteem Influences on Students Undertaking Personal Care Tasks

This paper focuses on social work students' experiences of a placement which entails providing intimate personal care for older people. It is based on data reported in a recent study (Fenton & Walker, 2011) and offers a reinterpretation of those findings. Their study is briefly outlined and the original interpretation, focusing on value-behaviour congruence, is summarised. Students' comments are then revisited, highlighting the potential of self-esteem theory to explain the processes at work. Employing a theoretical framework provided by the two-dimensional model of self-esteem (Mruk, 2006) it is argued that students' concerns about their placement experiences, and their beliefs about its benefits, can be understood in terms of perceptions of self-worth and judgements of self-competence. Links are made between this analysis and the model of value-behaviour congruence employed in the original study. Some implications for practice are considered.