Managing Guardianships of the Elderly:

Guardianships and conservatorships are currently used to carry out public policy concerning protection of and advocacy for elderly people who cannot care for themselves. This article analyzes this public policy with the idea in mind that the legal aspects of guardianships and conservatorships must be linked with clinical assessment in order for public agencies to provide high quality, need-based services for individual clients. The article also explores the notion that case management for such clients involves coordination of services between the court system and human services providers.     

Why do couples seek relationship help online? Description and comparison to in‐person interventions

Couples are increasingly utilizing newly developed online adaptations of couple therapy; however, different presenting problems could drive couples to seek either online or in‐person services. This study compared the presenting problems of 151 couples seeking an online couple intervention for relationship distress (OurRelationship) with responses from 147 couples seeking in‐person couple therapy. Presenting problems were generally consistent across gender and whether or not the respondent was the initial help‐seeker. Online and in‐person samples frequently endorsed difficulties with communication and emotional intimacy; however, they differentially endorsed trust, time together, and child/parenting difficulties. Therefore, while basing online interventions on existing couple therapies is generally supported, efforts should be made to tailor online services to meet the unique needs of this population.     

A portrait of homelessness.

The homeless elderly are vulnerable, silent, and fearful. Their trajectory into homelessness more often than not precludes recovery and takes them on a course toward early death or nursing home placement. Psychiatric nurses who work in community or acute care settings are in key positions to recognize elderly victims of homelessness, assess their needs, match them to services, start them on the road to recovery, and become their advocates. The definition of a homeless person as agreed on in the Report of the Federal Task Force on Homelessness and Severe Mental Illness (1992) is the one used in the Stewart B. McKinney Homeless Assistance Act (Public Law 100-77). A homeless person is someone "who lacks a fixed, regular, and adequate nighttime residence" and whose main nighttime residence is a "supervised public or private shelter designed to provide temporary living accommodations; an institution that provides a temporary residence for individuals intended to be institutionalized; or a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings." This definition, then, excludes those individuals living on the "fringes" in substandard or condemned housing, a condition that warrants attention in general and particularly among the elderly.     

Mental health and the aging: A review of the literature for clinical social workers

This article is a review of the literature on recent trends in mental health services to the elderly. The focus is on clinical services to elderly living outside of mental hospitals but includes services to residents of community nursing homes and homes for the aged. It is concluded that there is currently a non-system of services failing to meet present mental health needs. Current restrictive government reimbursement policies and national health insurance proposals are focused on treatment for acute episodic illness. This orientation does not permit a broader preventive perspective or a comprehensive mental health care approach.     

"Reasonable efforts": toward implementation in permanency planning

The "reasonable efforts" criterion for provision of services to the families of children in foster care and to the families of children at risk of entering foster care is designed to provide for external, and presumably more objective, monitoring by a court of the quantity and quality of these services. A standard of "reasonable effort" applicable to all cases in the two populations of concern is both impractical and probably unethical. Legally there must be a case-by-case determination of "reasonable efforts" that will weigh the unique elements of each case. It is hoped that the working guideline proposed here will provide a basis in child welfare practice for minimizing potentially great variations in court decisions. The guideline begins with a list of problems, verified via an adversarial review, as to why the child(ren) entered foster care or is at risk of doing so, followed by the establishment of the relevance of proffered services to those problems, followed by documentation of a sustained effort to facilitate the use of those services.     

Methodological challenges in the implementation and evaluation of social welfare policies

As social reality is quite elusive, even regarding seemingly well-recognized everyday concepts and objects, there are always methodological challenges underlying assessments and evaluations of implementation policies. The present article addresses this area of concern by presenting the results of a rereading of an empirical study of elderly home care services. Our results reveal the emergence of a dissolution of common and professional key concepts and objects in these welfare services to a degree that challenges both the implementation policy and the evaluation of policy. We claim that this has methodological implications for evaluation of implementation policies in general.     

Translation style and participant roles in court interpreting1

This paper investigates the translation styles of court interpreters in New York City and the styles' social and pragmatic implications for multilingual interactions in court. Interpreters are found to vary between using first or third person to represent the voice of a translated source speaker, thereby varying between adherence to explicit institutional norms that require first person and accommodation to non‐professional interpreting practices that favor the use of reported speech. In a quantitative and qualitative analysis, this variation is shown to be influenced by several pragmatic and social factors, and to index the interpreters' stances towards source speakers and towards the immigrant court users who are the recipients of translations from English. It is argued that translation styles have profound consequences for limited English speakers, as the insistence on institutional norms in translating to them is viewed as a gatekeeping behavior that may impede their full participation in the proceedings.     

Omnivorousness as the bridging of cultural holes: A measurement strategy

Recent research and theory at the intersection of cultural sociology and network analysis have converged around the notion of cultural holes: patterns of cultural choice that position the person as a bridge not between other persons but between cultural worlds. This is an approach that promises to open up new vistas in our conceptualization of the relationship between social position and cultural taste, but that so far lacks operational grounding. In this article, I draw on Breiger’s (1974) formalization of the idea of the duality of persons and groups along with classical formalizations of brokerage for sociometric networks (Burt 1992) to suggest that the “cultural ego network” of a typical survey respondent can be reconstructed from patterns of audience overlap among the cultural items that are chosen by each respondent. This leads to a formalization of the notion of omnivorousness as relatively low levels of clustering in the cultural network: namely, omnivorousness as cultural network efficiency. I show how this metric overcomes the difficulties that have plagued previous attempts to produce ordinal indicators of omnivorousness from simple counts of the number of cultural choices, while providing novel substantive (and sometime counter-intuitive) insights into the relationship between socio-demographic status markers and patterns of cultural choice in the contemporary United States.     

Clinical social work and the family court: A new role in child sexual abuse cases

Clinical social workers encounter difficult treatment issues when working with children where there is a suspicion of child sexual abuse, or where there has been an indicated child protective services case but no family court action. This article outlines a new role for the clinical social worker to play in relationship to the family court system. The author argues that the involvement of the clinician in an assessment process developed to aid the court can aid in the protection of children and set the stage for effective intervention and treatment.Director, Center for Training and Research in Child Abuse and Family Violence.     

Family Therapy with the Elderly

This article outlines health and lifestyle challenges to elderly persons and associated changes in their family systems. Flexibility, related to attachment patterns, is considered central to healthy adaptation. Family therapy approaches and relevant systemic and cultural factors influencing psychotherapy with the elderly are discussed. Key family therapy concepts and strategies (genograms, transmission of family histories and circular patterns of interaction), are reviewed and exemplified. Four types of family therapy presentations are elucidated by composite case examples. Firstly, the elderly person can be the identified patient. Secondly, another family member can seek help for him/herself in relation to the elderly person. Thirdly, another family member can be the identified patient without direct reference to the elderly person. Finally, the wider health care system involved with the elderly person and family can be the focus of therapy. Family therapy offers important conceptual and strategic advantages in working with the elderly and their systems.     

Culturally Competent Practice with African American Juvenile Sex Offenders

African American juveniles adjudicated for sexual offenses may struggle with the mistrust of both the judicial and treatment systems. Unlike general mental health services, juvenile sex offender treatment is often mandated by the court or child welfare services, thus these youths and their families must engage in the treatment process. Without clinicians and services that can acknowledge and respond to a minority youth’s experience in a sensitive, culturally competent manner, there could be significant resistance to treatment. Traditional treatment approaches fail to prioritize issues involving cultural competence. This article addresses the unique challenges of African American juvenile sex offenders and makes recommendations for creating culturally competent practice for these youth and their families.     

Informal caregiving for elders in Sweden: an analysis of current policy developments

In Sweden, care of elderly people is a public responsibility. There are comprehensive public policies and programs providing health care, social services, pensions, and other forms of social insurance. Even so, families are still the major providers of care for older people. In the 1990s, the family was "rediscovered" regarding eldercare in Sweden. New policies and legislative changes were promoted to support family caregivers. The development of services and support for caregivers at the municipal level has been stimulated through the use of national grants. As a result, family caregivers have received more recognition and are now more visible. However, the "Swedish model" of publicly financed services and universal care has difficulty addressing caregivers. Reductions in institutional care and cutbacks in public services have had negative repercussions for caregivers and may explain why research shows that family caregiving is expanding. At the same time, a growing "caregivers movement" is lobbying local and national governments to provide more easily accessible, flexible, and tailored support. In 2009, the Swedish Parliament passed a new law that states: "Municipalities are obliged to offer support to persons caring for people with chronic illnesses, elderly people, or people with functional disabilities." The question is whether the new legislation represents a paradigm shift from a welfare system focused on the individual to a more family-oriented system. If so, what are the driving forces, motives, and consequences of this development for the different stakeholders? This will be the starting point for a policy analysis of current developments in family caregiving of elderly people in Sweden.     

Naturally Occurring Retirement Community-Supportive Service Program: an example of devolution

Devolution is defined as the transfer of power or authority from a central government to a local government. This article addresses federal policies on housing for the elderly and the devolution of funding for federal senior housing and describes two aspects of devolution of federal housing policy for the elderly. One, it points out the decreasing interest in senior housing by federal authorities as indicated by the decreased amount of funds allocated for this purpose. Two, it emphasizes the need for supportive, assistive services for residents of senior housing and how federal funds have not addressed this need adequately or sufficiently. As a consequence, there have emerged Naturally Occurring Retirement Communities (NORCs) in New York State, a housing arrangement that provides supportive and health services to all eligible residents. The article concludes with a discussion of policy implications and the need for additional research before replicating this model.     

Resource allocations to the aged according to greatest social need

The purposes of the study reported on in this article were: (a) to explore the measurement of social need among the elderly, and (b) to develop an appropriate method for including social need in funding allocation procedures. Interview responses from over 4,000 randomly selected elderly persons were used to identify the demographic correlates of those having the most restrictions in their every-day lives. Procedures for intrastate allocations were developed using variables suggested by the Older Americans Act and by research to explain variance in activities of daily living. Variables tested for the model were: age, income, living arrangement, gender, ethnicity, area of residence, occupation, hospitalization, years in the neighborhood, language at home, and utilization of senior services. Prediction formula weights were adjusted (magnitude of beta i/sigma magnitude of beta i) to allocate resources to the proportions of 10 "high-need" groups residing in each planning area: the population aged 75 and older, the proportion of hospital discharges of elderly patients, elderly females, elderly non-Caucasians, the elderly not completing high school, elderly farm workers, elderly urban residents, a proportion for participation in senior services, for low-income elderly persons, and for the elderly not living with their spouses. Compared to current systems, the proposed procedure provides a closer fit to the actual needs of the elderly.     

The impact of expert evidence on care proceedings

There has been an increased demand for expert child psychiatric opinion in child care cases where social services have instigated care proceedings under the Children Act 1989. However, there has been little evaluation of this work in terms of whether such a referral changes the care plan of the referring social work agency or the outcome for the child. This article examines the contribution to care proceedings of assessment reports completed by a child and adolescent forensic psychiatry team in respect of 37 consecutive child care cases. All of the assessments were presented to court and the information was collated once the proceedings were completed. Our findings indicated that the court followed the recommendations of the child psychiatric report entirely in 73% of cases. In addition, in 86% of cases the social service departments reported that they had gained confirmation of their professional opinion. In only 10% of cases did they change their care plan in response to the child psychiatric assessment. In conclusion, the results suggest that in most cases social service departments are using child psychiatry expert evidence merely to validate and/or lend support to their original care plans. Copyright © 1999 John Wiley & Sons, Ltd.     

Long-term care policy for the elderly in the Zaporozhye region of Ukraine: a case study of social development following the collapse of Communism

In this paper, we review the status of social policy for the elderly in Ukraine since the fall of Communism and the breakup of the Soviet Union. We specifically address the problem of "rebuilding" an income and services policy for the at-risk elderly after the unraveling of the system that existed prior to the fall of Communism. Also, we address some existing problems faced by the elderly in the health care system. Within this context, we present a case study of the current status of long-term care policy for the elderly in one province of Ukraine, the eastern province of Zaporozhye, encompassing the industrial city of Zaporozhye on the Dnieper River. This case study particularly pays attention to current attempts to promote a social development process of long-term care services for the elderly. It examines recent developments with respect to public sector organizations and voluntary sector organizations that are trying to provide necessary services to the needy elderly. With respect to the voluntary sector, the paper pays particular attention to the American Jewish Joint Distribution Committee (JDC) model of a largely externally funded NGO that provides comprehensive and integrated social supports, while emphasizing local empowerment and the use of volunteers, for the needy Jewish population in the province of Zaporozhye. Based on our findings, we make some proposals regarding the improvement of income and services policy with respect to the elderly in Zaporozhye and Ukraine.     

Old Dreams,New Means: an Exploration of Visions and Situated Knowledge in Information Technology

The aim of this article is to explore the tensions and ambivalences of new and old technology and political visions of keeping viable, quality care and services for elderly citizens through the use of new information technologies. The visions of politicians and social service managers of keeping alive the welfare state and retaining its ability to offer quality care and services for elderly citizens are compared with the experiences of female care assistants and their expectations of technology. A feminist figure — the cyborg — will be used in this exploration. We consider how care assistants are integrated in networks of socio‐technical relations between humans and non‐humans, and the extent to which gender or asymmetrical power relations between women and men intervene in their stories.     

Independent Advocacy for Children and Young People: Developing an Outcomes Framework

This article draws on a study of the outcomes and impact of independent advocacy for children and young people to explore how the value of advocacy is understood by them and by professionals, and what differences advocacy can make to the lives of children and young people. Findings indicate that outcomes of advocacy can be significant and wide‐ranging, including both direct effects on the child or young person and wider impact on services. This has implications for how to capture and report the outcomes of advocacy, for which this article offers a new conceptual framework.     

Resource Allocations to the Aged According to Greatest Social Need

The purposes of the study reported on in this article were: (a) to explore the measurement of social need among the elderly, and (b) to develop an appropriate method for including social need in funding allocation procedures. Interview responses from over 4,000 randomly selected elderly persons were used to identify the demographic correlates of those having the most restrictions in their everyday lives. Procedures for intrastate allocations were developed using variables suggested by the Older Americans Act and by research to explain variance in activities of daily living. Variables tested for the model were: age, income, living arrangement, gender, ethnicity, area of residence, occupation, hospitalization, years in the neighborhood, language at home, and utilization of senior services. Prediction formula weights were adjusted (|ß_i|/Σ|ß_i|) to allocate resources to the proportions of 10 "high-need" groups residing in each planning area: the population aged 75 and older, the proportion of hospital discharges of elderly patients, elderly females, elderly non-Caucasians, the elderly not completing high school, elderly farm workers, elderly urban residents, a proportion for participation in senior services, for low-income elderly persons, and for the elderly not living with their spouses. Compared to current systems, the proposed procedure provides a closer fit to the actual needs of the elderly.     

Naturally Occurring Retirement Community-Supportive Service Program

Summary

Devolution is defined as the transfer of power or authority from a central government to a local government. This article addresses federal policies on housing for the elderly and the devolution of funding for federal senior housing and describes two aspects of devolution of federal housing policy for the elderly. One, it points out the decreasing interest in senior housing by federal authorities as indicated by the decreased amount of funds allocated for this purpose. Two, it emphasizes the need for supportive, assistive services for residents of senior housing and how federal funds have not addressed this need adequately or sufficiently. As a consequence, there have emerged Naturally Occurring Retirement Communities (NORCs) in New York State, a housing arrangement that provides supportive and health services to all eligible residents. The article concludes with a discussion of policy implications and the need for additional research before replicating this model.