The potential of domiciliary care service in the Czech Republic to promote ageing in place

Due to population ageing, the need for long-term care is increasing. In many European countries, there is now a firm policy preference for care in the home as opposed to institutional care and policies at the local level support this preference. The purpose of this study is to report on the position of domiciliary care service within the Czech social services for the elderly and to explore its potential to promote ‘ageing in place’. The aim of the research was to perceive this issue from the viewpoint of the different parties: service users, service workers, service managers as well as policy-makers. Therefore, the qualitative methodology (case study method) was used. The results revealed that users considered domiciliary care as the only service in the Czech Republic that allowed them to remain at home despite their worsening capacity to manage the activities of daily living. On the part of the domiciliary care service, however, we found that this was strong in the provision of practical help, as well as assistance with users' self-maintenance, whereas their supervision and care management were not explicitly included either in the concept or the practice of this type of service.     

Consumer-directed home and community services programs in eight states: policy issues for older people and government.

This study assesses consumer-directed home and community services for older persons by examining public programs that serve this population in eight states. These programs give beneficiaries, rather than agencies, the power to hire, train, supervise, and fire workers. Most stakeholders interviewed, in addition to the quantitative research, indicate that many older beneficiaries want to and can manage their services, although significant issues arise for persons with cognitive impairments. Research results suggest better, or, at least, no worse, quality of life for beneficiaries when they direct their services, although quality of services remains a contentious issue. For workers, consumer-directed care has some disadvantages, including fewer fringe benefits. With exceptions, state agencies have not provided extensive consumer or worker support or aggressively regulated quality of care.     

From neglect to partnership? Challenges for social services in promoting the welfare of Traveller children

This paper explores current and potential directions in social services' provision for Traveller children, drawing on a Nuffield‐funded study. Many Traveller communities experience harassment, racism and oppression, which create a structural ‘vulnerability’ for children. However, the paper focuses on services for children where structural and family vulnerability interact, and the extent of statutory neglect. After outlining the study, three models of provision are explored. Firstly, crisis response in relation to child protection and youth justice issues has dominated social services' interaction with Travellers, tending to reinforce existing difficulties in relationships between the two. Secondly, family support was the subject of initiatives beginning in the study areas (selected as more engaged with Traveller issues) to facilitate Travellers' access to services, and plan a more strategic engagement with Traveller communities. Thirdly, specialist work was represented both formally and informally in the study, and demonstrated considerable benefits. Lessons from these findings suggest priorities for developing work with Travellers: recognition of Travellers as a minority ethnic/cultural group; inclusion of Travellers in equality policy and practice; training for workers; changes to referral systems; development of community support services; specialist posts; support to, and outreach work in partnership with, voluntary agencies; interagency initiatives; and, crucially, consultation with Travellers. Copyright © 2000 John Wiley & Sons, Ltd.     

The case of Asian migrants to the Gulf Region

International migration from Asia to the Gulf Region is desirable and has benefited both individuals and the countries. At the individual level, migrants benefit economically and socially. They earn more income and are able to improve the quality of life of their family members when they return home. Although there are cases of negative impacts of international migration, such as fraud and corruption, as well as broken homes and extravagance, in general most migrants benefit and the experiences are worthwhile. Available data indicate that there are occupational shifts, a change in attitude towards community life, the world situation, and attainment of goals. At the national level, international migration has brought in foreign exchange and helped reduce unemployment. In addition to facilitating and making the pre-migration phase as easy as possible, activities of government during migration and post-migration phases are also required if the government is truly to promote international migration. Establishment of the post of Labor Attache in embassies will support migrants while they work abroad by providing services and moral support, thus making adjustment in host countries easier. Upon returning home, the government can provide consulting services to returnees on investment possibilities and may be able to tap resources form returnees for overall development. Granted that returnees are ordinary people with not much savings, remittances in foreign currency sent home have reduced financial difficulties in the home country. International migration is seen by the author as a rite-of-passage. This is an activity or an educational experience which happens once or twice in a lifetime and is not repeated. There must be a revolving system where young people migrate to work, gain experience, earn extra income, and return to settle down, bringing with them the benefits gained while working abroad. Data collected from this study show negative social impacts, especially when migration covers a long period in one's lifetime. In promoting international migration, the government therefore has to help returnees settle down and treat international migration as an educational experience.     

Work-family conflict among IT specialty workers in the US

Specialty workers are a source of critical, locally scarce technical skills. This study aimed to understand the experience of work-family conflict among specialty workers in the US by exploring the process of transitioning from working in their home countries to working in the US. While participants perceived initial difficulties in adapting to the new environment, over time, they experienced lower work-family conflict in the US compared to working in their own home countries. In their home countries, where work and family domains were considered separate and culturally defined boundaries separating these domains are rigidly maintained; these participants relied heavily on family support to manage work-family conflict. Moving to the US, where greater integration of work and family domains is prevalent, these participants managed work-family conflict by revisiting altered demands, accessing alternate organizational resources and learning new skills to create and maintain work-family boundaries. This study contributes to the nascent body of literature on work-family relations in the context of international migration by highlighting a specific case of Indian specialty workers who adopt different boundary-spanning strategies to manage work-family conflict in changed social and working conditions. In essence, participants managed work-family conflict by using enhanced autonomy to increase flexible working and accessing other resources such as supervisory support and organizational flexible working policies.     

Child deaths attributed to abuse and neglect: An empirical study

This study of 267 child deaths associated with abuse or neglect in Texas during 1975 through 1977 suggests a number of indicators for identifying potential child fatalities. Families where abuse or neglect is implicated in a child fatality are characterized by small family size, young parents, and under-utilization of community support services. Over three-fourths of the families in the study had never come to the attention of the state's child protective services agency. In addition, when fathers were present in the home, they were as likely to be involved in the abuse or neglect as mothers. Neglect was implicated in the death of a child as often as abuse. The study suggests the need for further examination of child fatality profiles associated with abuse and neglect and increased community outreach efforts to provide support to high-risk families, The study also has implications for social policy decisions, particularly in relation to efforts to resist attempts to exclude neglect from child protective service responsibility.     

The Use of Boundaries by Self-employed,Home-Based Workers to Manage Work and Family: A Qualitative Study in Canada

This qualitative study used grounded theory methodology to explore the experiences of 30 self-employed, home-based workers in Canada. Using boundary and work–family border theories as central theoretical constructs, this research examined the extent to which workers used boundaries to manage work and family, the nature of these boundaries, and how they were negotiated by the workers and their families. The results indicated that self-employed, home-based workers used both conceptual and physical barriers to create and manage the boundaries between home and work and that these boundaries were reinforced by rules. Gender differences and similarities were observed in the ways that boundaries were constructed and managed. Based on these observations, several areas for further investigation are proposed.     

Work–Family Conflict: Coping Strategies Adopted by Social Workers

There is a growing literature investigating the association between coping and work stress among social workers. An area that remains under-researched is the association between work–family conflict and coping. The present study explored the coping strategies adopted by social workers in dealing with the competing demands emanating from their work and family domains. In a larger study involving 439 Australian social workers, we analyzed the responses to two open-ended questions that explored the challenges experienced by social workers in meeting their work and family demands, and the coping strategies they adopt to deal with these challenges. The findings confirm that social workers experience work–family conflict and they adopt several coping strategies to deal with it including support from supervisors and colleagues, cognitive reframing, timely communication, setting clear expectations, time management, job flexibility and developing personal hobbies. We discuss the implications of our findings for social work policy and practice.     

The Restorative Power of Emotions in Child Protection Services

The paper examines the significance of our emotional life for validation, enrichment and guidance in everyday behavior. Child protection services (CPS) workers need to understand how emotions affect family dynamics and, in particular, parental behavior as a basis for their work with families. Moreover, in order for CPS workers to be aware of, and professionally responsive to, the importance of a family's emotions requires that they are comfortable with their own feelings. This means that they need to work in CPS agencies which recognize and support this practice orientation. The paper also addresses how the agency can influence CPS workers to become more knowledgeable and attuned to, not only the families' emotional lives, but also to their own.     

Older lesbians' experiences with home care: Varying levels of disclosure and discrimination

ABSTRACT

There is considerable evidence that lesbian, gay, bisexual and transgender (LGBT) older adults have experienced barriers to health care access and have profound fears about how they will be treated in the long-term care system, but the specific experiences of older lesbians have received less attention. Most older adults needing long-term services and supports (LTSS) prefer to remain at home, and this is true for lesbians as well. This article reports on a national, qualitative study of the experiences of 20 older lesbians (age 65 and older) with home care workers. The experiences of six informal partner caregivers with home care services are also included. Emergent themes regarding level of disclosure, experiences with homophobia, evaluation of care received, and thoughts about ideal LTSS are described. Most study participants did not disclose their sexual orientation to their home care workers. A significant minority experienced homophobia, but nearly all ultimately found workers who provided good care with which they were comfortable. Their visions of ideal LTSS included greater affordability and particular qualities that were important for home care workers to possess, such as competence, caring and acceptance. Practice and policy implications are outlined including careful recruitment, training and supervision of home care workers to foster lesbian-sensitive care, but also improved wages and work conditions in order to maintain a quality home care workforce.     

Empowering Community-Based Programs for Youth Development

This article discusses the need for community-based programs for youth and their families and urges the social work profession to resume its historical leadership in such programs while incorporating recent theory and practice. The authors describe the reasons why social workers abandoned neighborhood-based youth development services, the intended outcomes of such services, and current societal and professional trends that support a revival of social work’s involvement in youth development. They discuss one school of social work’s current participation in a youth agency partnership and examine implications of the suggested revival for social work education. Collaboration among families, schools, diverse community services, agencies, and educators is emphasized.     

Health Status,Living Arrangements,and Service Use at 100: Findings From the Oporto Centenarian Study

ABSTRACT

This paper describes the sociodemographic characteristics, health status, and service use of centenarians living in the community and centenarians residing in an elder care facility/nursing home and examines their main differences. Participants were 140 centenarians from the population-based Oporto Centenarian Study (M_age = 101.2; SD = 1.6). Main findings revealed that the majority of the centenarians lived at home with their family members (57.9%). Increased health care needs, living alone, and family caregiving constraints were the most common reasons for entering a nursing home. Community-dwelling centenarians were cared for mostly by their children and were less dependent and in better cognitive health than those who resided in a nursing home. Differences were found in the pattern of health service use according to the centenarians’ residence, ability to pay medical expenses, and dependency level. Findings highlight the need for an accurate assessment of caregiving support systems, particularly family intergenerational duties, and of the factors constraining the access and use of health and social services. Policy makers may be guided by the insights gained from this research and work toward improvement of support options and removal of barriers to service access.     

Forging an Identity as a Newly Qualified Worker in the Non-government Community Services Sector

Forging a professional identity is commonly assumed to be a key objective for new graduates transitioning to work. However, the extant literature on professional identity development gives minimal consideration to the role of contemporary work conditions such as increased contract-based employment and occupational instability in carving out a work identity. These workforce trends are particularly pronounced in the non-government community services sector, where worker mobility is high and workers often occupy roles that are not profession-specific. In light of these trends, this article seeks to broaden existing understandings of professional identity development. Focus groups were conducted with 24 newly qualified workers with degree-level qualifications in social work and the human services employed in the community services sector in Queensland. The findings suggest that these workers held a variety of allegiances, which were not necessarily aligned with a profession but instead shaped by the interplay of personal, professional, and organisational factors.     

FAMILIES’ CARE OF THEIR CHILDREN WITH SEVERE DISABILITIES IN AUSTRALIA

In Australia, from the 1980s, the processes of de-institutionalization and non-institutionalization have resulted in most children with severe disabilities being cared for at home. Current Australian government policy suggests that care increasingly will be undertaken in the home. The needs of families, then, is an area that requires attention. The findings in this paper are drawn from a series of qualitative in-depth interviews with parents of children with severe disabilities and, in particular, I highlight issues raised in relation to income, work, leisure and social relationships. Typically, despite the provision of formal (and informal) support services, participation in the wider community is limited. I argue that the provision of support services has been inadequate to enable engagement in activities that other families take for granted and that greater social policy attention is warranted.     

Quality of life of older people in Israel: a comparison between older people living at home who are members of a ‘supportive community’ and nursing home residents

The supportive community is a program that was developed in Israel for older people who live at home. The program provides its members with a service package that includes medical and social services, emergency call-button, cultural activities, and a ‘community parent’ who is responsible for the members. Using quantitative method, this study compared the level of quality of life between 55 older people living in their homes who are members of a supportive community (average age = 74.7) and 60 elderly people living in nursing homes (average age = 75.8). As expected, results indicate that quality of life among the older people living at their homes who are members of a supportive community was higher than among the older people living in a nursing home. In addition, the quality of life of married, educated, functionally independent older people in good health and with a good economic situation was higher. Predictor variables of quality of life were: the place of residence, health status, and age. In light of increased life expectancy and the growing need to care for the older population, the practical application of the study focused on a recommendation for the social services to continue the support community development program.     

Adult youth workers’ conceptions of their work in an under-resourced community in the United States

This study examined adult workers’ conceptions of their work with youth in a large, underserved, urban region in the northeastern United States. Drawing on qualitative interviews with 18 youth workers from various organizations, affiliated with a community coalition focused on substance abuse prevention, we explored how adults viewed their role of working with youth. We were particularly interested in whether these workers saw youth empowerment and collaboration with youth for community change as part of their role. Our data suggested that while workers in this study were very supportive of youth, the support and actions they provided were on behalf of rather than with them and that, in general, partnering with youth for community change was not a part of what they envisioned their work to be. While a few of the adults attempted to work more collaboratively with youth, they were clearly in the minority.     

Serving children and adolescents in the school: Can social work meet the challenge?

Educators recognize that social, personal, and environmental conditions can interfere with childrens' learning. As a result, educational reforms have emphasized family support services and the provision of social and related services at or near the school. However, the entry of agency based social workers into the school has not sufficiently taken into account the role of pupil personnel staff, including school social workers. Findings from a state study that examined the population served and services provided by school social workers are discussed in light of the implications they have for collaboration between school and agency social workers working within the school.     

Measuring outcomes in family support services (a case study using respite care)

Measuring outcomes in family support services is a relatively new area of social research. This study aimed to explore the use of respite care (brief planned periods away from home with the same carers over several months) as a family support service to help prevent long term family breakdown. It studied the service from the perspectives of all those involved in it—social workers, carers, parents and children–and was funded by the UK Department of Health as part of a series of studies commissioned to explore the implementation of the English Children Act law and theory.     

Social Workers’ Observations of the Needs of the Total Military Community

Researchers surveyed licensed social workers from 5 Mid-Atlantic states to explore their perspectives on the current state of mental health and service delivery for military service workers, families, and contractors. Social workers identified needs in the following areas: mental health, physical health and wellness, social and environmental, interpersonal and family, and military-specific needs. The majority of needs were most critical during the postdeployment stage. Education related to the observed needs was reported; social workers were most interested in learning about military culture and how to coordinate resources within the community to support the total military community. Suggestions for social work education and future research are discussed.     

Do the Benefits Justify the Costs? An Evaluation of the ‘Sitter Service’ in Scotland

This research identified the costs and benefits of the sitter service in Scotland. A ‘sitter service’ is one that provides home‐based childcare outside the hours of 8:00 am to 6:00 pm on weekdays and at weekends to support children of shift workers, single parents/carers and for children who require additional support. Nine sitter services, organised by voluntary or not‐for‐profit organisations in Scotland, were contacted; their costs were compared and the views of sitters and users identified. For very little expenditure, they provided a service that resulted in a range of individual and community benefits. However, the research concludes that most sitter services are hat small scale and piecemeal funding endangers their long‐term viability.