Recent developments in institutional elder care in China: changing concepts and attitudes

This study examines recent developments in institutional care for Chinese elders and attitudinal changes toward institutional care in Tianjin, China. Based on studies in 12 elder home sites and survey interviews with 265 older residents, this study compares institutional differences between government and non-government-owned elder homes, and examines elders' evaluations of elder homes' quality and their level of willingness to stay in elder homes. Findings suggest that government-owned elder homes still enjoy institutional and bureaucratic privileges in funding, staffing, and insurance. Elders' overall evaluation of elder home quality was high. Elders' former living arrangement and financial ability were related to their willingness to stay in the elder home. The unfair competition between governmental and non-governmental elder homes is likely to hinder the development of elder home industry in the free-market system and foster a growing gap between the rich and poor elders in their capability and decisions in elder home care. As adult children become increasingly unavailable due to the one-child policy and geographic mobility, institutional care for aging parents is likely to become one of the major options for parent care.     

Depression and elder abuse and neglect among a community-dwelling Chinese elderly population

Our recent survey of an elderly cohort in mainland China suggests that elder abuse and neglect are common. Unfortunately, there is minimal knowledge about the risk factors for elder abuse and neglect among this population. We aimed to examine depression as a risk factor for elder abuse and neglect among Chinese elderly. A cross-sectional study was performed in a major urban medical center in NanJing, China. Depression was assessed using the Geriatric Depression Scale and direct questions were asked regarding abuse and neglect experienced by the elderly since the age of 60; 412 patients completed the survey. The mean age of the participants was 70 and 34% were female. Depression was found in 12% of the participants and elder abuse and neglect was found in 35% of the participants. After multiple logistical regression, feeling of dissatisfaction with life (OR, 2.92; 95% CI, 1.51-5.68, p < 0.001), often being bored (OR, 2.91; CI, 1.53-5.55, p < 0.001), often feeling helpless (OR, 2.79; CI, 1.35-5.76, p < 0.001), and feeling worthless (OR, 2.16; CI, 1.10-4.22, p < 0.001) were associated with increased risk of elder abuse and neglect. Multiple logistic regression modeling showed that depression is independently associated with elder abuse and neglect (OR, 3.26; CI, 1.49-7.10, p < 0.003). These findings suggest that depression is a significant risk factor associated with elder abuse and neglect among Chinese elderly.     

The attitudes of medical professionals toward children and children at risk of separation from parents in Eastern Europe

This article reports the findings of a multi-country study of medical professionals' perceptions and evaluations of children. The primary aim of the study was to establish the perceptions medical professionals working in three Eastern European countries (Romania, Bulgaria, Moldova) hold toward children identified as “typical”, “at-risk” and “with disability”. A second aim was to explore the existence of country-level differences in medical professionals' perceptions of children. The third aim was to examine the pattern of associations between attitudes toward children and a change in use of institutional care to family and community-based alternatives. Over 800 respondents provided survey responses using paper-based and online returns. Findings indicated that positive affect toward children was associated with the favourability of attributes generated about “typical” children. In contrast, positive affect toward children was associated with less favourability toward at-risk children. Attribute favourability ratings generated for at-risk children were positively associated with attributes generated for children with disability. Differences were identified between respondents working across the three countries. No association was identified between attitudes toward children and endorsement of a statement supportive of de-institutionalisation as part of child protection reforms. These findings illuminate how children are conceptualised and understood by a group of medical professionals who hold considerable sway over decisions and recommendations about their relative risk and vulnerability.     

Autonomy on the horizon: comparing institutional approaches to disability and elder care

Theory and Society - This article asks how people come to interpret themselves and others as autonomous given their multiple dependencies. We draw on a cross-case comparison of ethnographic studies...     

Intergenerational solidarity between parents and adult children: a qualitative research among cohabiting and married children in Italy

The objective of this article is to compare the patterns of intergenerational solidarity between adult children who cohabit or are married and their own parents or their partner's parents through the analysis of 50 in-depth interviews. The research did not reveal any different behavioural patterns between cohabiting and married couples. Financial support provided by own parents or partner's parents and the presence of small children constituted positive factors which intensified the frequency of contacts and improved the quality of the relationship. In the event of illness of a parent, both the married and cohabiting couples provided assistance, especially when the illness was not disabling and there were no other kin relatives. When this was not possible, a private caregiver was hired or close family members provided assistance. Only those respondents who cohabited with a partner awaiting divorce were less willing to maintain contacts with their partner's parents. The presence of a family formed by previously married partners and the old age of the parents of the latter compromised the quality of the relationship and the willingness to provide assistance.     

Fostering homeless children and their parents too: the emergence of whole-family foster care.

Children should not be placed in out-of-home care simply because their families lack the means to provide for their basic needs, yet this practice continues nationwide. A new program based in St. Paul, MN, gives county social service departments the placement option of whole-family foster care. The target population is adult parents and minor children without stable residences, where the children are at risk of placement in out-of-home care. Although the parents and children may have special needs, there are no safety risks that would necessitate separating children and parents. The program's design is described and policy questions discussed.     

Helping parents with mental illnesses and their children: a call for family-focused mental health care

1. Large numbers of individuals with mental illnesses are parents to minor children. 2. Recommendations to improve services suggest that services provided by the adult mental health system and child service agencies be coordinated. 3. Nursing care intersects both the adult and child systems, and nurses have the expertise to offer a variety of services. 4. There is an urgent need to improve family-focused mental health nursing care to benefit parents with mental illnesses, their children and families, and the overall community and society.     

Self-concept and attitudes toward adoption: a comparison of searching and nonsearching adult adoptees

This study showed that nonsearchers and searchers are different from each other on almost every measure that was applied. Research on and experience with searching adult adoptees should not be applied to nonsearching adult adoptees. Likewise, research on and experience with nonsearching adult adoptees should not be generalized to searchers . The results of this study do not support the belief that adoptees, in general, have low self-concepts and identity conflicts, or that adoptees need information about their biological families and reunions to resolve their identity conflicts. Although the sample of pre- and post-reunion searchers was small, reunions did not make a significant difference in self-concept or identity conflicts, as measured by the TSCS . The results of this study do not support the theoretical bases often cited to justify open records. Specifically, adult adoptees in this study do not have negative self-concepts, did not experience poor adoptor - adoptee relationships, and the majority did not experience revelation of adoptive status as disruptive or late. Although significant differences exist between the comparison groups, an important finding is that of all the adult adoptees, the majority scored above the sixtieth percentile on the TSCS and had positive scores on the Attitude Toward Parents Scales. Furthermore, they were happy growing up, with only 12% reporting being unhappy. These findings support the conclusions of Day [1979] and Norvell and Guy [1977] as well as the belief that adoption is a legitimate way of building families.(ABSTRACT TRUNCATED AT 250 WORDS)     

Interviewing parents of children in care: Perspectives, discourses and accountability

The ‘parental perspective’ in child care work is a matter of concern and is actively solicited by practitioners, managers, policymakers and researchers for differing reasons. This paper argues that the search for such a stable “parental perspective” should be abandoned and suggest that research should embrace a social constructionist turn by concentrating on how parents' views are negotiated conversationally in discourse. Using data drawn from research interviews with parents of children in care and employing conversation and discourse analytic methods, the paper demonstrates how there are critical issues of accountability, blame, and testing at stake in the interview encounter, as interviewer and interviewee jointly produce a moral version of the client, the institution, the case and its attributes. The implications of this argument are delineated.     

Elder care as "frustrating" and "boring": Understanding the persistence of negative attitudes toward older patients among physicians-in-training

ObjectivesThis study explores the attitudes of physicians-in-training toward older patients. Specifically, we examine why, despite increasing exposure to geriatrics in medical school curricula, medical students and residents continue to have negative attitudes toward caring for older patients.MethodsThis study used ethnography, a technique used by anthropologists that includes participant-observation, semi-structured interviews, and facilitated group discussions. Research was conducted at two tertiary-care academic hospitals in urban Northern California, and focused on eliciting the opinions, beliefs, and practices of physicians-in-training toward geriatrics.ResultsWe found that the majority of physicians-in-training in this study expressed a mix of positive and negative views about caring for older patients. We argue that physicians-in-trainings' attitudes toward older patients are shaped by a number of heterogeneous and frequently conflicting factors, including both the formal and so-called “hidden” curricula in medical education, institutional demands on physicians to encourage speed and efficiency of care, and portrayals of the process of aging as simultaneously as a “problem” of inevitable biological decay and an opportunity for medical intervention.DiscussionEfforts to educate medical students and residents about appropriate geriatric care tend to reproduce the paradoxes and uncertainties surrounding aging in biomedicine. These ambiguities contribute to the tendency of physicians-in-training to develop moralizing attitudes about older patients and other patient groups labeled “frustrating” or “boring”.     

Issues of shared parenting of LGBTQ children and youth in foster care: preparing foster parents for new roles

Foster parents have increasingly assumed new and challenging roles during the past decade. Meeting the developmental, attachment, and grieving needs of children and youth in out of home care is challenging by itself, but can become even more difficult with the issues that arise when the child is lesbian, gay, bisexual, transgender, or questioning (LGBTQ). Preservice and in-service foster parent training programs can strengthen shared parenting skills by focusing on the universal critical issues of safety, well being, and permanence for children and youth in foster care. This article will focus on these skill areas: (1) sharing parenting to promote healthy growth and development of LGBTQ youth in foster care, (2) threats to safety of LGBTQ youth in foster care, and (3) general challenges and strategies for preparing foster parents of LGBTQ youth to build support systems.     

Developmental outcomes among Korean adolescents in out-of-home care: A longitudinal study comparing kinship foster care and institutional care

Kinship foster care has recently become the new main form of Korean out-of-home care, and has reached similar usage proportions as the more traditional form, institutional care. To compare the effectiveness of the two care types, we focused on adolescents' developmental outcomes. We also examined changes over time in the outcomes and group differences in the changes. We analyzed five-year longitudinal data from 244 adolescents who participated in the Panel Study on Korean Children in Out-of-Home Care. A repeated measures Analysis of Variance (ANOVA) was used as the major analytic method. The study results revealed that the kinship group was better off at the baseline for covariates than was the institution group for almost every development measure. However, the group differences observed at baseline disappeared or reversed in direction, which indicated better longitudinal outcomes for the institution group. In terms of changes over time, self-esteem and delinquency of all adolescents, no matter to which group they belong, changed in a positive way. However, there were no group differences in the patterns of changes. Based on these results, we discuss the limitations of the Korean out-of-home care system, such as the lack of assessment and monitoring, and support for kin caregivers.Ethical approvalWe obtained informed consent from the participating adolescents and Sookmyung Women's University IRB (the first through the third wave panel research) and Ewha Womans University IRB (the fourth and the fifth wave) approval before we began this research.     

Reciprocity in relationships: socio-economic and health influences on intergenerational exchanges between Third Age parents and their adult children in Great Britain

In this paper data from a nationally representative British longitudinal study are used to analyse exchanges of support between Third Age parents (aged 55-75) and their adult children. Results show that between two thirds and three quarters of parents in this age group were involved in some sort of exchange relationship with at least one of their children. Generally, more Third Age parents were providers than recipients of help, but there was a strong reciprocal element to intergenerational exchange with, for example, married parents who provided support to at least one child being twice as likely as those who did not to receive support from a child, after allowance for a range of relevant parental and child characteristics. Parental characteristics associated with higher probability of providing help included higher income, home ownership and being married or widowed rather than divorced. Higher income and home ownership were, however, negatively associated with odds of receiving help from a child, again after adjustment for other co-variates, suggesting socio-economic differences in the balance of support exchanges. Children seem responsive to parental needs in that receipt of help from a child was positively associated with older parental age and with parental disability. The paper shows that in Britain, as in the USA, the balance of intergenerational exchanges involving Third Age adults is downward rather than upward, in contravention of depictions of older adults as 'burdens' on younger generations. Current demographic and social changes are, it is argued, likely to increase support demands from adult children to Third Age parents in coming decades.     

Parents and their young adult children: transitions to adulthood

This paper considers how parents are affected by and play a role in the lives of their young adult children. The years during which young people make the transition to adulthood has changed significantly in recent years--this transition now takes place over a longer period of time. We describe how young people experience these years; how they affect their parents and parent-child relationships; and how this time period is experienced by vulnerable youth.     

Understanding of elder abuse and neglect among health care professionals in Malaysia: An exploratory survey

ABSTRACT

Elder abuse and neglect (EAN) is a hidden public health challenge for Malaysia. This cross-sectional survey studied the awareness of EAN among 148 doctors and nurses from two neighboring states in Malaysia using a self-administered questionnaire exploring their knowledge, perceptions, practices, and experience concerning EAN. Both doctors and nurses demonstrated poor understanding of signs of EAN and exhibited misperceptions on reporting requirements. Both groups perceived EAN as a national burden and reporting it as their responsibility; but most felt they had not been trained to diagnose it. Many were unsure of procedures and whether their own intervention could be effective. Only four (nurses) of 41 participants who suspected abuse during the past year reported the cases. Targeted education and uniform protocols are mandatory to ensure best practice with regards to EAN. Further research is crucial to extend this inquiry into the broader health care workforce.     

Individual values,cultural embeddedness,and anti-immigration sentiments: Explaining differences in the effect of values on attitudes toward immigration across Europe

During the last decade, many European countries have faced sizeable immigration inflows accompanied by high prevalence of negative sentiments toward immigrants among majority members of the host societies. We propose that basic human values are one important determinant of such negative attitudes, and we seek to explain variation across countries in the strength of the effects of values. Based on Schwartz’ (1992, 1994) basic human value theory, we hypothesize that universalism values are conducive to positive attitudes toward immigration, while conformity-tradition reinforce anti-immigration sentiments. We furthermore hypothesize that these value effects are moderated by two contextual variables. Both value effects are expected to be weaker in countries with a higher level of cultural embeddedness. Furthermore, negative effects of conformity-tradition values are hypothesized to be cushioned by a lower proportion of immigrants in the country. A multilevel analysis of data from 24 countries from the fourth round of the European Social Survey (2008–2009) supports these hypotheses. Moreover, we demonstrate that the measurement properties of the theoretical constructs exhibit equivalence across countries, thereby justifying statistical comparisons.     

The new dropout challenge: bridging gaps among students, parents, and teachers

Interview and survey data reveal significant disconnects among the insights and perspectives of dropouts, parents, teachers, and administrators on the causes and solutions to the dropout challenge. Many educators, for example, do not see boredom as a factor for most dropouts, while young people who drop out see it as the central cause. The author argues that if these disconnects are not more fully understood and bridged, they will continue to set back efforts to keep more students in school and on track to graduate ready for postsecondary education. Models for how communities can engage these constituencies in productive dialogue and transformative action are included in reports and in Grad Nation, a guidebook that helps communities tackle their dropout crises.     

Comparing public attitudes toward providing for the livelihood of the elderly in two aging societies: Germany and Japan

Using an ordered logit model on representative survey data, we study attitudes about who should provide for the livelihood of the elderly in two aging societies—Germany and Japan. We find that in both countries, those with higher income are more inclined toward the private option, whereas age has the opposite effect. Part-time work status negatively (positively) affects the inclination toward a government-based pension system in Japan (Germany). Other significant influences are the pensioner status of the respondents in Japan and specific left-wing party support in the case of Germans.