A qualitative evaluation of an innovative resilience‐building camp for young carers

Young carers are at increased risk of developing mental health and social problems. The objective was to pilot a camp‐based resilience‐building programme for young carers. Twelve young carers (12 to 14 years) recruited from Carers Queensland attended a 3‐day resilience‐building camp adapted from the Resourceful Adolescent Program. One month after the camp, carers participated in a semi‐structured telephone interview. Thematic analysis was used to analyse the data. Two key themes emerged. The first, coping self‐efficacy, included subthemes of affect regulation, interpersonal skills, and recognition of strengths and coping ability. The second key theme, social benefits, included opportunities for respite and social engagement. Overall, participants reported enjoying the camp and would recommend it to other young carers, yet they were able to provide some suggestions to improve future camps. Implementing an integrative resilience‐building program such as the Resourceful Adolescent Program in a camp format shows promise as a way of both engaging and benefiting young carers, as well as selective populations more generally.     

Poetry

This paper describes the services and procedures of the Philadelphia Geriatric Center's multi-service respite service demonstration project for 305 caregivers of elderly Alzheimer's patients. Selected sections of data are reported that provide information needed by professionals for planning and delivering such services. Of all caregivers who were offered respite, 52% actually availed themselves of the services. Of those, two-thirds chose in-home services, with smaller proportions using day care and institutional respite. Reasons for such choices and for the non-use of respite, the advantages and problems of different types of respite, and implications for development of respite programs are discussed.     

The Right to Take Risks: Alcohol and Older People

This paper examines policy and practice regarding the purchase of alcohol for older clients of home carers in three local authorities in the Greater London area. Data were gathered from interviews with home carers and their managers, focus group discussions, and a postal survey. None of the local authorities had a written policy or written guidance on alcohol purchase or on appropriate responses to the identification of problematic drinking in older clients. The findings illustrate the problem of balancing "rights" and "risks" within a philosophy of community care which emphasizes client choice and autonomy, and show how policy and practice are "tailored" by local contexts. It is suggested that both home carers and other domiciliary workers, as well as their older clients, could benefit from a clear code of practice regarding responses to alcohol consumption and problematic drinking by older people.     

Short Term Care for the Elderly in Residential Homes: A Research Note

Please address requests for reprints to Dr. D. Boldy, Division of Health Sciences, Centre for Advanced Studies, Western Australian Institute of Technology, Kent Street, Bentley WA 6102, Australia. Summary Short term care for the elderly has expanded rapidly in thelast five years. The study evaluates short stay care in fourresidential homes using interviews with 42 clients, their main‘carers’, officers-in-charge of the homes and socialworkers. Whilst the service worked reasonably smoothly and provideda break for family carers there remains further potential forimproving the quality of service in the context of a full rangeof services for elderly people.     

Strengthening kinship families: scoping the provision of respite care in Australia

Kinship care is the fastest growing form of out‐of‐home care in Australia, as it is in many other countries. The Victorian Government's response has been to establish 18 programmes across the state to provide support to kinship families. The scoping project described here, based on interviews with key programme staff, explores the experiences of the new programmes in providing support, specifically respite care, to kinship families. It has produced a picture, based on qualitative and quantitative data, of how respite care is understood, the perceived respite needs of kinship families, how services are organized and provided, identified barriers to families accessing support, the effect of respite provision and what constitutes optimal practice. The findings establish a basis for a best practice model of service provision for this increasingly significant family type.     

Personal Attributes of Rural Service Providers as Correlates of Role Effectiveness

Thb study inquires who deals more effectively with the elderly: workers of their same age or younger service providers? Findings tend to favor the latter: younger workers showed more positive attitudes toward their aged clients. They would also consult them and involve them more often in service programming than older workers.     

Importance Counts: The Role of Relative Importance of Service Elements in Client Satisfaction Measures

ABSTRACT

It is not uncommon for social work service providers, researchers, and evaluators to develop measures to obtain client satisfaction data relevant to their particular service settings. These measures are often constructed through a set of (usually Likert-type) satisfaction rating response items for each of the service elements relevant to their settings. Scores from these multiple items are then either summed or averaged to produce global satisfaction scores. By summing or averaging satisfaction scores across all items, one implicitly assumes that all survey items that represent various service elements carry equal weight. This assumption of equal weight is somewhat counterintuitive because individual clients may perceive certain survey items or service elements to be more important, or carry more weight, than others. Analyzing data from interviews with 112 clients of an elderly case management service agency in a large city in the Midwest region of the United States, this study examined this equal weight assumption in an elderly case management service setting. Results indicated that not all service elements were considered equally important, which called into question the common practice of summing or averaging satisfaction scores of various service elements to represent global client satisfaction.     

How Social Workers Demonstrate Respect for Elderly Clients

Although respect is a crucial aspect of social work practice, few studies have examined how social workers convey their respect for elderly clients. This study explored the various forms of respect demonstrated by social workers when they were with older clients. Fifty social workers serving elderly clients were surveyed by a questionnaire with closed- and open-ended questions. Based on data on ways the social workers respected their elderly clients, the study identified 7 forms most frequently practiced and considered most important. They are linguistic respect, care respect, acquiescent respect, salutatory respect, presentational respect, spatial respect, and consultative respect. The key expressions of these forms are introduced in quantitative data and a narrative form. These findings provide insight as to how social workers exhibit respect for elderly clients in their practice. The results of this exploration may be useful in developing a more comprehensive typology of the forms signifying respect for elderly clients.     

ELDERLY HUSBANDS CARING AT HOME FOR WIVES DIAGNOSED WITH ALZHEIMER'S DISEASE: ARE MALE CAREGIVERS REALLY DIFFERENT?

In Australia, there is a dearth of literature available on men as principal carers despite reports which show that in the 60 + age group, looking after a sick spouse becomes the major form of caregiving and men as carers predominate (ABS, 1993). The paper reports findings from a study of 26 aged husbands who cared at home for their cognitively impaired wives. In‐depth interviews collected quantitative and qualitative data about men's caregiving experiences. Findings challenge the literature about the role gender plays in evoking care and service responses. Results show how men demonstrated a strong injunction to care, performed intimate personal care tasks competently, received limited government support and derived some satisfaction from the caregiving role. Despite similarities between male and female caregivers being noted, some gender differences in the way in which men approached the care role are described. The need for community care policies to be more sensitive to the gendered context of elderly care provision is discussed.     

The nature and prevalence of kinship care: Focus on young kinship carers

Young kinship carers tend to be overlooked in kinship care policy and practice. This Australian research project explored the prevalence of kinship care households in Australia, with a particular focus on households headed by young kinship carers. Census data were utilized to explore the number of kinship care households across the carer age spectrum and some of their characteristics, including households with Indigenous carers and carers with a culturally and linguistically diverse (CALD) identity. Characteristics of households headed by carers aged 16–30 years were explored in some detail, and comparisons made with young parents. The data pointed to particular challenges for young kinship carers in relation to post‐secondary education, employment and income security. Implications for policy and practice are discussed.     

Using research in practice: A research information service for social care practitioners

In recent years a variety of initiatives have been created with the aim of increasing the use of research in social care practice. This article reports findings from a one‐year pilot research information service provided by the What Works for Children project. Taking note of the evidence from the research utilization literature, the service was set up to support social care practitioners in using research findings in their service‐planning. An implementation officer worked with service‐planners to identify areas where research could be helpful. Researchers provided responses to practitioners’ questions by searching for, critically appraising and summarizing the relevant literature. This article looks at the practicalities of running such a service and discusses its potential for influencing research use. The pilot underlines the importance of some of the obstacles to using research, some of which our service was able to overcome. The gap between what practitioners want from research and what research provides is discussed.     

A stress process model of family caregiver service utilization: factors associated with respite and counseling service use

This study examines whether caregivers' differential utilization of respite and counseling support services is associated with different situational stress processes. A multinomial regression analysis was conducted to compare respite users, counseling users, and those who used neither service, using data collected on a statewide random sample of 1,643 California caregivers providing assistance to individuals aged 50 or older. Compared with caregivers who used neither service, respite service users were more likely to have demanding care situations giving rise to physical symptoms of stress, and were more likely to use community services for the care recipient to augment their care. In contrast, counseling service users were more likely to be managing the meaning of their care situation by seeking out information about services and talking with a confidant about their situation, while coping with both emotional and physical symptoms of stress. Tailoring caregiver interventions to meet the support needs and coping strategies stemming from diverse caregiving situations and caregiver characteristics may increase the likelihood that those interventions will be effective in alleviating or preventing deleterious secondary stress frequently experienced by family caregivers.     

Key Issues for Social Workers Placing Children for Family Based Respite Care

Correspondence to Dr. Carol Robinson. Summary This paper seeks to address some of the issues surrounding theplacement of children with handicaps who, at their parent'srequest, go to stay with paid carers working in a family basedrespite care service. The content of the paper derives froma detailed evaluation of the Avon Respite Care Scheme. Thisevaluative study began in April 1984 and was completed in July1986. In order to provide an adequate picture of the contextin which the research was conducted, a brief outline of theliterature and the organization and philosophy of the serviceis provided. Thereafter, the aims of the research and the sourcesof the evidence used are described. In the latter part of thepaper. the results and their implications for social workersinvolved in placing children in family based respite care schemesare discussed.     

灾后学校社会工作“优势为本”的实践——以“社区公益行”为例

本文以四川灾区某学校社会工作社区服务为例,总结并反思了灾后服务过程中优势为本的实践,包括理念、服务原则、服务框架及服务内容,并对其服务模式进行了深入的探索。笔者认为,优势为本的社会工作服务能综合服务对象自身及环境优势,促进服务对象的成长以及与环境的良好互动,进而增强服务对象的自信,提升服务对象应对自身及环境压力等方面的能力。     

灾后学校社会工作“优势为本”的实践——以“社区公益行”为例

本文以四川灾区某学校社会工作社区服务为例,总结并反思了灾后服务过程中优势为本的实践,包括理念、服务原则、服务框架及服务内容,并对其服务模式进行了深入的探索。笔者认为,优势为本的社会工作服务能综合服务对象自身及环境优势,促进服务对象的成长以及与环境的良好互动,进而增强服务对象的自信,提升服务对象应对自身及环境压力等方面的能力。     

Charging and Quasi-Markets in Community Care: Implications for Elderly People with Dementia

Social services authorities in the UK are increasingly involved in charging and fee collection activities with clients in receipt of community care services. This article explores the implications of these developments for elderly people with dementia. The starting point of the article is a critique of existing legal and administrative options for handling other people's money, including the difficulties and dilemmas raised for both paid and unpaid carers by the existing arrangements. This is then related to the failure of charging and fee collection systems which have developed as a result of the community care reforms to address the particular needs of elderly people with dementia. A case study of policies in one local authority is outlined and this is followed by the presentation of the view of 37 fieldlevel professionals who were interviewed in focus groups. The concerns of these respondents included the complexity of the assessment task, conflicts between care managers and finance/revenue staff, the difficulty of defining and responding to financial abuse, and dilemmas over the extent to which relatives and carers should be trusted. The final section of the article considers the implications of a move to quasi-markets in social care for elderly people with dementia, particularly in terms of their vulnerability to financial exploitation.     

The Ebony Project- Bicultural Group Work with Transracial Foster Parents

The project encompassed groups for black children in white foster homes and also a group for the white carers, which forms the main topic of this paper. The group aimed to assist the carers to consider what special needs their foster children had, as well as challenging their understanding of the impact of racism in society and of their own assumptions. The ethnicity of group workers, the consultant and of other agency staff were all highly relevant to the success of the group and to the particular difficulties it encountered. The bicultural worker team was especially valuable in confronting the defensive attitudes which prevailed amongst group members. The Ebony project demonstrates the potential for innovative group work practitioners to redress the failings of a past era when ethnicity was frequently simply ignored and when the needs of service users were consequently not appropriately met.     

An Outcomes Focus in Carer Assessment and Review: Value and Challenge

Correspondence to Elinor Nicholas, Research Fellow, Social Policy Research Unit, University of York, Heslington, York YO10 5DD, UK. E-mail: en2{at}york.ac.uk Summary A focus on outcomes and a desire to improve assessment and supportto carers are central to government policy, crystallized inthe 2000 Carers and Disabled Children Act. This paper exploresthe benefits and challenges of implementing an outcomes approachto carer assessment and review, highlighted by a research anddevelopment project, undertaken in partnership with one localauthority. The project developed and tested research-based practicetools which aimed to promote carer-centred practice, togetherwith clarity in communication and recording of outcomes intendedand achieved. Findings indicated that practice could be enhancedwith the help of a clear conceptual framework and tools, flexiblyand sensitively used to assist discussion and decision-makingwith carers about outcomes. Information about outcomes, aggregatedfrom individual records, was perceived as potentially usefulfor informing service development. Some significant obstaclesand challenges also emerged; not least, the subtle but significantculture shift required, and the additional time needed to effectivelyidentify and address outcomes with carers. A number of factorswere highlighted as important in introducing such an approach:collaboration with, and between, all stakeholders; trainingand support for practitioners to include practice in recordingoutcomes, and opportunities for continuing discussion and reflectionduring implementation.     

Challenging Professional Roles: Lay Carers' Involvement in Health Care in the Community

The bulk of care in the community is carried out by lay carers. Recent policy initiatives to support them in the United Kingdom are outlined. There remains evidence of significant gaps in support from professional health and social‐care workers including community nurses. This paper reports three studies of lay carers: those caring for older people, carers of technology‐dependent children, and home‐care workers involved in the “direct payments” scheme. Findings are reported in the areas of decisions about appropriate caring roles, the lay–professional boundary, training and respite opportunities and the expertise of lay carers. Recommendations for policy and practices are made.