THE ELDERLY BLIND IN NURSING HOMES

This article addresses a number of issues surrounding the problem of delivering services to elderly blind residents in nursing homes. It is pointed out that general public misunderstanding, blind service agencies' lack of resources and general nuising home problems like high staff turnover rates make it difficult to establish ongoing effective training programs. It is argued that rigorously evaluated trainings could solve some of the problems involved in coordinating the blind service system and nursing home network to establish a national in-service training policy on blindness for staff who work with elderly blind in nursing homes.     

Social Workers' Responses to Incontinence,Confusion and Mobility Impairments in Frail Elderly Clients

Social workers in home health care agencies are frequently involved in decisions concerning the independent living of their frail elderly clients. This study analyzes social workers' responses to elderly clients with three health problems that are relatively common among the elderly: urinary incontinence, confusion, and mobility impairments. Responses to clients with incontinence differ from responses to confused or mobility-impaired clients primarily in the specificity of attributions of cause of the problem and in evaluative responses toward the client. The findings are discussed in terms of the potential role of social work as an agent for change in both popular understandings of incontinence in later life and in the delivery of health care to the incontinent elderly.     

Countertransference Issues in Social Work With the Aged

Despite their growing number, their increased risk of mental disorders and social dysfunction, the elderly continue to be underserved by mental health workers. Two of the major obstacles to appropriate treatment and services for the elderly and their farnilies are countertransference and death anxiety. This article examines these issues through the use of case examples. It suggests that mental and social service agencies need to concern themselves with and provide opportunity for supervisors to review practitioners' work in order to identify countertransference issues and ageist stereotyping.     

Factors in Differential Utilization of Services by Urban Elderly

This paper examines the extent to which people aged 60 years and over living in the inner city of New York utilize community services. It was found that agencies providing income maintenance were utilized by the highest percentage of fhe respondents, followed, in order, by the police, religious organizations, and the housing authority. Among the lowest in reported utilization were voluntary social agencies such as settlement houses and family service agencies. There was also a low level of utilization of visiting nurse and homemaker services. Differences in utilization were found among ethnic groups represented in the population. Reasons for the low level of service utilization are discussed.     

Irish women and street politics, 1956–1973: ‘This could be contagious’ by Keenan-Thomson,T.

Group work is viewed as a substantive tool for meeting many of the needs of persons served in our health and welfare system. Group work has a proud history of service in traditional group service agencies and there is evidence indicating that schools of social work must continue to train future generations of practitioners to serve ever-broadening populations of children, families, and the elderly with regard to social interactional needs created in our society through depersonalization and isolation. The use of groups to serve school populations, the physically and educationally handicapped, and high-risk elderly Americans is detailed. Educational directions for schools of social work are discussed.     

Sensory Loss

Hearing and vision losses are among the most corn- rnon chronic conditions affecting elderly people. Individually, each loss can be a major threat to independence and the quality of life; the combined loss of both hearing and vision creates a whole new world-muffled, blurred, and disorienting. Traditionally, social work- ers have left issues of sensory loss lo the rehabilitation specialists. Yet sensory loss is a psychosocial problem, and social workers have a great deal to offer. This paper describes a demonstration project in which a social worker coordinated the work of specialists in two agencies, provided direct service, and identified some ways in which social workers in a variety of settings might address Ihe service needs of this large and growing population.     

Services Provided by Elderly Volunteers

As the number of elderly persons increases, the social service needs of older Americans will grow too. To provide a variety of services, many social service agencies across the nation are helping the elderly organize to help themselves. This paper represents the second of a series of research reports derived from a federally funded research project to investigate the types of services that trained elderly volunteers provide to other elderly persons in the community. This paper presents a multivariate analysis of elderly volunteers who go beyond providing socializing and reassuring services and provide instrumental services. The independant variables are developed to capture the level of the physical and mental strengths of elderly volunteers. Theses strengths are psychological functioning, perceived health, psychological adjustment, and social resources. In addition, program-participation factors, such as the duration of participation in the volunteer project and the number of persons served, as well as variables related to demographic and educational backgrounds, are included in the analysis as controls. The major findings from this study are the following: (1) Among the independant variables, perceived health is a statistically significant predictor of a volunteer's becoming a provider of instrumental services; (2) The volunteer's level of education and the number of elderly persons served are also statistically significant predictors. One the whole, however, elderly volunteers perfer socialization and reasurance over instrumental services when they try to help other elderly persons.     

Elderly Victims of Family Abuse,Neglect, and Maltreatment:

Analysis was conducted on 30 cases of elder abuse, neglect, and maltreatment of the elderly seen by attorneys in a legal aid agency in Detroit between 1979 and 1981. The data were collected as part of a larger study of elder abuse cases seen by a variety of agencies in the Detroit area. Analysis revealed that most of the victims suffered from more than one type of abuse or maltreatment. As might be expected, the most common type of abuse seen in the legal aid agency was financial abuse. The study also showed that a legal agency can provide a type of service other agencies cannot provide. These services include: court actions, non-court actions which require the service of a lawyer, and non-legal actions in which an attorney can bring about action through the perceived threat of court action.     

Implementing child mistreatment risk assessment systems: lessons from theory

Over the past ten years, public child protective services (CPS) agencies have adopted risk assessment systems in an effort to improve the quality of service delivery to children and their families. Various reviews of the impact of these models suggest that they have not lived up to their expectations and have had little or no impact on broad system indicators of service delivery. Foremost among the findings of existing studies is that these models have not been implemented and used as intended. The risk assessment field has not taken advantage of theoretical principles suggested by the organizational change literature. The researcher applies Lewin's Force Field Analysis to identify the forces for and against effective implementation of risk assessment systems in public agencies. The author suggests that lessons from theory could improve the effectiveness of the implementation of change in CPS agencies.     

The Utilization of Social Services by the Mexican-American Elderly

One of the knowledge gaps in empirical research on utilization of service is that little attention has been given to testing causal models of use among the various ethnic elderly groups. The purpose of this study is to analyze the pattern of determinants of social service use among the Mexican-American elderly. A causal model of social service use was tested using a subsample of data obtained from a national needs assessment interview of 1,805 randomly selected noninstitutionalized elderly Hispanics. The findings, indicate that knowledge of social services, need for social services, perceived health status and income have direct effects on the use of social services. The major findings are discussed in relationship to past empirical research.     

A family support service for homeless children and parents: user and staff perspectives

Children and their parents who become homeless constitute a group of families with a complex range of social care and health needs, including mental health difficulties. In response to this, a local authority housing department established a family support team (FST) that provides assessment and detection of a range of problems, support to parents and children, parenting interventions for child behavioural problems, liaison with other agencies, and referral to specialist services when appropriate. The aim of this study was to establish the perceptions of parents and staff on their experience of the service, and ways of improving it in the future. The study adopted a developmental evaluation approach and used multiple methods, including in‐depth interviews with families; diaries; reflective activities; participatory learning and action; and observation of the FST. The study mapped the innovative service and captured the range of skills in the team and the complexity of agencies the team interacted with. It also identified areas for further development in terms of the mental health needs of children and parents who have become homeless.     

Working Together Apart

In this paper we report upon the development and operation of a “street-level” response to the problems of interprofessional joint working in providing appropriate care for elderly people living in one Scottish city. The “exchange system”, as it was known in the locale, was a mechanism for co-ordinating the movement of elderly people between the geriatric, psychiatric, and residential services within the city in response to changes in the needs of the individual elderly person, and the needs of service providers. The importance of the scheme stemmed from the fact that it was not imposed on professionals' work, but rather that it developed out of that work. By focusing on the operation of interprofessional joint working at the street level we draw attention to those complexities involved in such work which are often overlooked in the broad policy statements on joint working which have emerged from government departments, and health and social services agencies. Policy makers and analysts alike have largely ignored the meaning and consequences of joint working at the level of professionals' actual work, and it is this lacuna in the literature that the paper seeks to address. The paper concludes with an appeal to researchers and practitioners to describe any such schemes of whatever nature operating in their own locales. In so doing a corpus of knowledge looking critically at the experience of interservice and interprofessional collaboration at the street level may emerge which would inform broad policy statements.     

Reaching Inner-City Children

One of the obstacles faced by community social service agencies is difficulty in attracting adolescents to the services offered them. Adoldscents typically do not walk in or keep appointments at outpatient clinics and can be difficult to engage even for outreach programs. One solution to this dilemma is to go where the children are: the public schools. One of the biggest problems in the Boston public school system is that many students and their families have pressing social, emotional, and physical needs that are not being met outside the school and that adversely affect their education. The schools are educational institutions, not human service agencies, and they are ill prepared to deal with many of the problems and needs of their students' lives. In 1984, an independent board composed of representatives from the Boston Public Schools, state, city, and private social service agencies, parents and students, secured funding and formed the Boston Student Human Services Collaborative. The mission of the Collaborative was to supplement and expand support services to the schools. The hope was that such services would free up both children and teachers to invest in each other, thereby increasing learning. This paper describes the group work component of a Collaborative program at an inner-city school. After a brief look at the inner-city context, the group work program model is presented as a case study, including specific types of groups that have worked well and details of recruitment, composition, goals, activities, and leadership roles. Following this is a discussion of race, color, and ethnicity, and then a list of guiding principles for working with middle school adolescents in groups.     

Keeping the Faith: The Impact of Human Services Restructuring on Catholic Social Welfare Services

Church related agencies are major providers of community services in Australia (Lyons, 2001:34‐35). While the history of church related welfare service provision is not well known in Australia it is asserted that many have a long tradition of outreach and service provision to marginalised groups regardless of the government social policy of the day (ACSWC, 2000; Mendes, 2003). This paper examines the current environment of human services restructuring and the impact of the shift to contractualism on one church related provider: Catholic social welfare provision in Australia. It explores the significance of the church's social teachings and history on concerns that service innovation, diversity and advocacy are currently under threat. Finally it calls for greater appreciation of the distinctive contribution of church related agencies and what they have to offer in service delivery and as contributors to the social policy discourse.     

Mobilizing Community Services for Adolescents in Trouble

Considering the low self-image of many adoles- cents who are experiencing social, educational and emotional problems, it is suggested that we initiate helping efforts from a wellness perspective. Social agencies often create barriers to troubled adolescents through their administrative structure and emphasis on pathology. Through the collaboration of a family service agency and public recreation department, an outreach program is described that makes use of recreational activity as an entry point for a range of social, educational and mental health services. The use of-community agencies and involve- ment of the adolescents and their parents in setting goals are vital parts of this integrative approach.     

Does partnership funding improve coordination and collaboration among early childhood services? – Experiences from the Communities for Children programme

Partnerships among service providers are an important aspect of human service delivery, including in the early childhood and family service sector. There is extensive international literature on factors contributing to partnerships – also termed service coordination, collaboration or integration – but little evidence of partnership outcomes exists where partnerships are a funded and mandatory component of large‐scale programmes. This paper reports findings from an evaluation of the Australian Government's Communities for Children (CfC) programme. Under CfC, partnerships were mandated and funded, and the evaluation findings show that the programme resulted in an increased number of agencies working together to support families with young children (0–5 years) and that working relationships between agencies improved. The effectiveness of these partnerships depended on funding for partnership activities and on organisational and practical factors.     

Division of Responsibility in Care of the Aged

Not all elderly people need special care. This review refers to the dependent minority and to the services they need. Brief mention is made of the history of services which began with charitable relief by voluntary action, and the current relationship between government bodies and voluntary agencies is outlined. It is maintained that division of responsibility for the various types of care should be based on assessment of individual needs, decentralization of control, together with evaluation of the resources of the agencies concerned.     

Assessing families and other client systems in community-based programmes: development of the CALF

Programmes providing services to children and families often face the challenge of assessing not only the child referred, but also the child’s family system and its individual members. Recognizing that household/family members can cause, contribute to or affect a child’s problems requires that human service agencies utilize assessment tools capable of assessing family members across the lifespan. The literature references many assessment tools used by clinical programmes in mental‐health settings that are not well suited to use in social service agencies with multidisciplinary staff at different skill levels. As a response to this dilemma, the authors have developed the Collaborative Assessment of Life Functioning (CALF), a user‐friendly tool that assesses various areas of life functioning. Based on Maslow’s motivation theory, person‐in‐environment and systems theories, the CALF can be used with various client systems. This paper describes the development of the tool, its purpose and use, the importance of assessment tools in the helping process and considerations for agencies wishing to use an assessment tool like the CALF. The authors also discuss the applicability of the CALF in human services and social service agency settings and with diverse client populations.     

Individual- and Contextual-Level Factors Affecting the Use of Social Support Services among Older Adults

ABSTRACT

By 2060, the number of Americans aged 65 and older is expected to more than double, while the number of Americans aged 85 and older is expected to nearly triple. As the nation's aging population grows, older adults will need to rely on social support services, such as transportation and housing services, in order to remain active and lead independent lives. In this study we use data collected from the elderly supplement of the Southeastern Pennsylvania Household Health Survey (SPHHS) (n = 3,042) to explore the relationship between the availability of elderly specific social service providers and utilization of social support services among older adults. We find that while the number of elderly specific social service providers can increase use of social support services among older adults, its impact is relatively minimal. We find that individual factors, instead, are stronger predictors of service use. This is a finding that should be particularly encouraging for elder care providers who may not have the resources needed to undertake large structural changes (like building new facilities). Still, future research should explore how the availability of a broader range of elderly specific social services (than explored in this study) impacts use.     

A New Approach to Community Care for the Elderly

Summary Organisations can absorb successfully only a few fundamentalinnovations within a short period of time. It is therefore importantfor the designers of innovations to ensure that they directlyand substantially contribute to solving important problems,and for agencies to concentrate their innovative activity onthose that do so contribute. The first aim of this paper isto analyse the policy context so as to clarify the nature ofthe problems that make innovation in the care of the elderlyimperative and show how features of the Community Care Projectcontribute to their solution. The second aim is to provide somepreliminary evidence of the success of the scheme. The analysisof data for seventy persons in the experimental and controlgroups shows that the experimental group fared better in a numberof important ways; and that the gains appear to have been madeat no extra cost to the social services department. Therefore,it is concluded, the adoption of the scheme may contribute tothe technical progress needed in the provision of social serviceto the elderly with needs at or above the margin for residentialcare.