Perceived discrimination,traditional practices,and depressive symptoms among American Indians in the upper midwest

American Indian adults are thought to experience significant depressive symptoms at rates several times higher than adults in the general population, yet we know very little about factors associated with depressive symptoms among this under studied group. Many researchers have argued that depressive symptoms are associated with conflicts between American Indian traditional cultural values, practices, and beliefs and those of the majority culture. This report, based on a sample 287 American Indian adults from the upper Midwest, takes into account two measures of cultural effects: perceived discrimination, as one indicator of culture conflict, and traditional practices, as a measure of cultural identification. The results indicate that discrimination is strongly associated with depressive symptoms among American Indian adults and that engaging in traditional practices is negatively related to depressive symptoms. Moreover, interaction effects between perceived discrimination and traditional practices indicate that engaging in traditional practices buffers the negative effects of discrimination among those who regularly participate in them.     

Kinship Care: A Cultural Resource of African American and Latino Families Coping with Parental Substance Abuse

SUMMARY

This paper examines kinship care as a cultural resource used by African American and Latino families coping with substance abuse by a family member. Although there is a growing body of literature on kinship care, there are no conceptual or empirical studies that have drawn or built on cultural similarities between these two groups of ethnic minority families. A framework that prioritizes cultural assessment and relevance in using familial and cultural resources is proposed to assist practitioners confronted with the demographic realities of working with social, clinical and ethnocultural complexities when serving ethnic minority families. The framework is based on practice implications raised by recent studies on kinship care and from the perspective of pertinent cross-cultural and anthropological literature.     

Perspectives on American Kinship in the Later 1990s

This paper reviews the current status of kinship research in the United States and identifies factors that might account for the declining interest in the subject among family researchers. The analysis uses both structural and cultural factors to illustrate how they can determine the diversity in kinship functioning that ranges from those family systems where kinship relationships flourish and those where they play a small part in family life. The structural and demographic variables determine the numbers and availability of kin, whereas the cultural variables determine the norms that establish the motivation to sustain kinship bonds. To illustrate how these factors operate among subgroups in the United States, I analyze three types of kinship systems: the lineal emphasis in White families of the very old; the collateral emphasis in the families of their Black counterparts; and the egocentric emphasis of White suburban families that are undergoing marital change.     

Parenting in Later Life: A Cross-Cultural Study

This study explored older parents’ beliefs about their parental role with their adult children, their perceptions of intergenerational conflicts between themselves and their adult children, and the negotiation of autonomy versus dependence with adult children in later life. The influence of cultural norms and mutual dependence on these intergenerational relationships was also evaluated. Focus groups were conducted with two groups of older adults attending a senior center in New York City—one who identified as American and the other as Asian Indian. Implications of the findings and recommendations for social workers are highlighted.     

Birthday celebrations as a family homelessness intervention: a mixed-methods analysis

Families report that the experience of homelessness presents a significant barrier to family functioning and interrupts regular family routines. This study uses data from 22 homeless shelters in Massachusetts to examine the relationship between birthday parties for homeless children, family functioning, and parent well-being in homeless families. The study includes a sample of 255 residents across 20 homeless shelters in both urban and rural communities that received regular monthly birthday parties from a nonprofit agency. A small comparison sample of 25 residents came from two shelters that were not receiving birthday parties from the nonprofit agency. Data from 78 staff members working at all 22 shelters was collected on shelter environment and resident cohesion. Results indicated that residents in those shelters that received monthly birthday party celebrations for children had higher levels of happiness. Residents’ satisfaction with the birthday parties showed correlations between levels of hope, happiness, and parental empowerment. Shelter staff who reported higher levels of satisfaction with birthday parties also reported higher levels of resident cohesion. Results point toward the value of continuing regular family routines, such as annual birthday celebrations, to help mitigate the stressors and disruptions of homelessness on families.     

Connective complexity: African American adolescents and the relational context of kinship foster care

Attempts to address racial disproportionality in child welfare must include a focus on the benefits and challenges facing children in kinship care. African American children not only are overrepresented in the child welfare system, but also are placed disproportionately in kinship foster care. Using a sample of 18 African American adolescents ages 11 to 14, this article explores how the relational context of care experienced by adolescents in kinship foster care differs from that of adolescents in nonkinship foster family placements. Findings are presented regarding the stability of relationships as well as complex role dilemmas experienced by kinship youth as they relate to caregivers and birthparents in the child welfare context. Implications are given for practice with kinship families.     

Re-examining child welfare's response to ICWA: Collaborating with community-based agencies to reduce disparities for American Indian/Alaska Native children

Many state and county child protection systems (CPS) are attempting to reduce the documented disproportionality in out of home placement rates for American Indian/Alaska Native children. This article presents a case example of collaboration between Colorado CPS and an urban American Indian family services agency that was intended to impact this disproportionality. The Denver Indian Family Resource Center created and evaluated a family preservation model that includes both direct services to Native families and CPS-level systemic interventions designed to reduce out-of-home placement. Direct services addressed family stressors and caregiver substance abuse and mental health issues, and incorporated Native cultural values. Systemic interventions focused on collaborative partnerships and provided CPS with practical ways to comply with the Indian Child Welfare Act. Agency data showed an increase in the number of children remaining at home or with extended family. Statewide data showed a decrease in the disparity ratio for placement of Native children compared to White children.     

Becoming institutional bodies: Socialization into a long-term care home

This paper reports the findings from a phenomenological study examining the lived experience of moving to a long-term care facility and the process of socialization for new residents into the nursing home culture and environment. Three residents were followed over the first six months after moving to a long-term care facility using a series of in depth interviews and participant observation with residents themselves, staff members and family members. This paper focuses on the five institutional level processes related to socialization into the long-term care environment as they were experienced by the new residents. These included: placing the body, defining the body, focusing on the body, managing the body, and relating to the body. The findings point to the importance of place in the construction of institutional bodies in the long-term care context.     

Staff-resident interaction in the nursing home: An ethnographic study of socio-economic disparities and community contexts

In recent years, nursing home (NH) researchers have paid increasing attention to socio-economic and racial/ethnic disparities in quality of care. Although there is growing evidence of disparities in resident health outcomes, less is known about the ways in which these differences manifest in care processes from a qualitative perspective. This paper addresses this gap by comparing staff-resident interactions in two urban, non-profit NHs, including roughly 50 staff participants in each facility. The researcher conducted ethnographic observation in one facility serving a white, middle class community and another serving low-income Black and Hispanic clients from an underserved neighborhood. Grounded theory methods generated three categories of interaction—activating, relating, and attending—which were performed differently in the two NHs. In the more affluent facility, staff interacted with residents in a dynamic fashion, adapting to residents’ responses, and they were relatively well equipped with resident-specific information when responding to individual concerns. In the safety-net facility, staff interacted with residents in a one-directional, “didactic” fashion, providing instruction without a mechanism for adapting to residents’ responses, and they were not as well equipped with resident-specific information. These differences reflected disparities between the two facilities in staff communication skills, underscoring the importance of workforce development to enhance the quality of staff-resident interaction and promote resident-centered care. This study raises further questions about the role of neighborhood contexts in shaping organizational processes that influence quality of life for NH residents. Moreover, the study offers a unique contribution to the NH literature by generating a typology of styles of interaction that can be used to develop a conceptual framework for understanding staff-resident interaction in the nursing home. Such a framework can inform efforts to improve residents’ quality of life.     

Resident and family perspectives on assisted living

This research describes and compares the relative importance residents and family members place on attributes of the environment, the programs, and the policies of assisted living; describes their satisfaction with these features; and identifies factors associated with congruence between residents' and family members' ratings of importance and satisfaction. Both residents and their family members had high importance and satisfaction ratings. Family members gave the assisted living setting lower satisfaction ratings on all features than did residents. Congruence ranged from 34% to 71% for importance items and from 29% to 63% for satisfaction. Female residents, affectionate family relationships, and residing in an AL owned by a chain were positively associated with congruence on importance items, while resident and family education, resident income, and family involvement were negatively associated with congruence on importance items. For congruence on satisfaction items, having an affectionate relationship was positively associated and higher ADL dependency, more family involvement at the facility, and family members who viewed the facility as a safe place were negatively associated with congruence. This study makes a major stride forward because cognitively intact residents' perspectives are compared and contrasted with their own family members' perspectives, thus showing that residents and family members are two distinct groups, each with a unique set of preferences.     

Architectural Space in Respite and Intermediate Care: An Actor-Network Theory Analysis

This article presents an analysis of 2 short-term care facilities using actor-network theory with the aim of revealing performative processes in different networks in the buildings in use. The 2 facilities differed in architectural design, which was expected to influence their care model and organization. One facility was larger and accommodated 4 patients/residents in double rooms as well as permanent residents who stayed in single rooms. The other facility was smaller and accommodated only short-term care patients in single rooms. The study revealed that the latter facility received more care-demanding people than the other. The size and the type of patients/residents influenced the social environment. The larger facility was more busy and lively than the smaller one. However, the analysis did not show any difference in quality of care or ambiance. Both facilities were valued as either good or bad by different residents or staff members. The study concludes that therapeutic values and outcomes are defined and redefined in the ongoing performances of everyday interactions.     

Identifying the barriers and challenges to voting by residents in nursing homes and assisted living settings

To ascertain the need for and to inform development of guidelines for voting in long-term care settings, we conducted a telephone survey of Philadelphia nursing (n = 31) and assisted living (n = 20) settings following the 2003 election. Substantial variability existed in procedures used for registration and voting, in staff attitudes, and in the estimated proportion of residents who voted (29%+/-28, range 0-100%). Residents who wanted to vote were unable to do so at nearly one-third of sites, largely due to procedural problems. Nearly two-thirds of facilities indicated they assessed residents' voting capacity before the election. However, methods differed and may have disenfranchised residents who were actually competent to vote. Current procedures in many facilities fail to protect voting rights. These data suggest that rights might be better protected if election officials took charge of registration, filing absentee ballot requests, ballot completion, and trained LTC facility staff on voters' rights and reasonable accommodations.     

Resident and Family Perspectives on Assisted Living

Abstract

This research describes and compares the relative importance residents and family members place on attributes of the environment, the programs, and the policies of assisted living; describes their satisfaction with these features; and identifies factors associated with congruence between residents' and family members' ratings of importance and satisfaction. Both residents and their family members had high importance and satisfaction ratings. Family members gave the assisted living setting lower satisfaction ratings on all features than did residents. Congruence ranged from 34% to 71% for importance items and from 29% to 63% for satisfaction. Female residents, affectionate family relationships, and residing in an AL owned by a chain were positively associated with congruence on importance items, while resident and family education, resident income, and family involvement were negatively associated with congruence on importance items. For congruence on satisfaction items, having an affectionate relationship was positively associated and higher ADL dependency, more family involvement at the facility, and family members who viewed the facility as a safe place were negatively associated with congruence. This study makes a major stride forward because cognitively intact residents' perspectives are compared and contrasted with their own family members' perspectives, thus showing that residents and family members are two distinct groups, each with a unique set of preferences.     

Suicide in Adolescent American Indians: Preventative Social Work Programs

Suicide is a leading social problem among the adolescent American Indian community. This literature review examines the demographics of American Indian adolescents who attempt suicide, along with the effects it has on the entire family/community. This paper describes various programs used to address individuals, while correlating them to specific use within the American Indian population. The authors look at the effectiveness of the Adolescent Suicide Prevention Project, American Indian Life Skills Development Curriculum, and Zuni Life Skills Development, along with the draw-backs associated with the implementation of each program. The importance of incorporating culturally specific programs and addressing the issue at a community level in an attempt to enhance the well-being of at-risk American Indian Adolescents is emphasized.     

Facility Ownership and Resident Satisfaction with Assisted Living

Abstract

Although the majority of assisted living facilities operate as for-profit organizations and serve increasingly frail elderly populations, little is known about the impact of ownership on the quality of care in assisted living. This study examines the relationship between facility ownership and the quality of care in assisted living, using resident satisfaction as a quality indicator. The assessed aspects of satisfaction include health care, housekeeping, physical environment, relationships with staff, and social life/activities. The relationship of facility ownership to resident satisfaction is examined controlling for resident psychological well-being, functional ability, facility size, and staff resources. Data were collected in personal interviews with 156 residents, including 96 residents in eight for-profit facilities and 60 residents in five nonprofit facilities in Maryland. Residents in the sampled nonprofit facilities were more satisfied with assisted living than were residents in the for-profit facilities. In particular, residents in nonprofit facilities were more satisfied with health care, physical environment, and social life/activities in the facility. Better understanding of the relationship between facility ownership and resident satisfaction can help administrators create environments that maximize resident satisfaction in both nonprofit and for-profit facilities.     

Willingness and availability: Explaining new attitudes toward institutional elder care among Chinese elderly parents and their adult children

This paper studies the attitudes of Chinese elderly parents and their family members toward institutional elder care. Based on a sample survey of 265 elderly residents in 67 elder home institutions and 114 family members, this study finds that elders and family members generally had high evaluations of institutions' quality in terms of facility, medical, and direct care conditions. Elders who reported improved health and emotional well-being after entering institutions gave higher ratings to those institutions' quality. Among adult children, those who had more siblings tended to rate institutions higher than those who had fewer siblings. Factors that influenced elders' willingness to stay in an institution included marital status and financial ability. Widowed elders were more willing to stay in institutions compared with married counterparts. Elders who rated service charge very high preferred to stay at home due to the high cost of institutional care. In the family relatives' sample, gender was found to be related to willingness to place elderly parents in an institution; female children were less willing to place elderly parents in the institution.     

Kinship care of the abused child: the New Zealand experience.

The concept of continuity--keeping children within their own kinship, community, and cultural networks--has found international favor in contemporary child welfare practice. This principle is reflected in the 1989 New Zealand Children, Young Persons, and Their Families Act. The Act represents a significant shift--from the state to the family--in responsibility for children in need of care. The increasing use of the Family Group Conference process allows families to make decisions about the future of kin children and reflects the belief that, although most abuse is intrafamilial, the family will also be the most committed to keeping the child safe. Other countries have adapted this model to suit their own cultural child welfare needs. The international trend toward formal use of kinship care for children who have suffered abuse or neglect is likely to continue as foster care resources shrink. Drawing on qualitative research, this article describes the experiences of caregivers and their kin children who have been the subject of a care and protection order.     

Family Members' Reports of Non-Staff Abuse in Michigan Nursing Homes

Recent research showed that mistreatment of nursing home residents by other residents may be highly prevalent. The present study examined the issue from family members' perspectives. The data came from the 2005 and 2007 random-digit dial telephone surveys of Michigan households with a family member in long-term care. Based on family members' reports, about 10% of nursing home residents aged 60 and over were abused by non-staff in nursing homes (e.g., other residents and visitors) during the past 12 months. Family members were more likely to report non-staff abuse when the nursing home residents were younger, were female, had behavior problems, and had greater level of physical functioning. Family members who reported staff abuse were four times more likely to also report non-staff abuse.