Role Conflict among Family Childcare Providers in the Bronx

Family childcare (FCC) providers provide childcare for many low‐income families in the United States, and the literature suggests they take on several other support roles as well. The current study consisted of focus groups and interviews in which FCC providers (N = 22) shared successes and challenges in their profession. Using grounded theory we identified four primary FCC roles: teacher, caregiver, social worker and business owner. Conflict within and between roles was related to considerable stress. Because roles varied across a spectrum from entangled to rigid professional relationship boundaries, many FCC providers struggled with the limits of their daily work. Suggestions are made to limit role conflict, re‐establish boundaries and promote FCC providers’ well‐being.     

Financial Abuse of Older People by a Family Member: A Difficult Terrain for Service Providers in Australia

Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.     

Mom and Pop Versus the Big Boys: Adult Family Homes as Providers of Medicaid-Funded Residential Care

This paper compares assisted living apartments (ALs), adult residential care facilities (ARCs), and small adult family homes (AFHs) for Medicaid residents in Washington State, with particular emphasis on the settings, staffing, services, and policies of AFHs. We targeted for enrollment all residents entering an AFH, ARC, or AL setting on Medicaid/state funding in a three-county area of Washington State. We obtained information on 199 settings, interviewing administrative and direct care providers. AFHs are smaller than ARCs and ALs and less likely to be part of a chain, with no significant difference in staffing ratios of registered nurses and licensed practical nurses. Sixty-four percent of AFH residents were receiving public funds compared to 32% of AL residents. AFHs report admitting residents with more activities of daily living needs, health conditions, and behavior problems. They are less likely to have autonomy-related policies, and they provide more services and fewer activities. While attention should continue to be paid to staff supports, policy and practice should support the continued role of AFHs, which are of special interest because of their potential to provide more homelike, less costly care but with possible trade-offs compared to larger facilities.     

Trade-Offs Between Formal Home Health Care and Informal Family CareGiving

Using 1994 National Long Term Care Survey data, we estimated logistic regressions of formal and informal home health care use and hours. Home health care use and intensity were differentially impacted by chronic conditions, are higher for Medicaid enrollees and rural or small town residents, but lower for HMO enrollees. Decreases in the probability of home health care use increased informal instrumental activities of daily living (IADL) support four hours and decreased informal activities of daily living (ADL) support eight hours weekly. IADL caregiving substituted for formal care, but ADL caregiving declined with reductions in formal care. Public policy reducing formal home health care access may reduce informal ADL caregiving and increase informal IADL caregiving, producing net declines in support.     

Family Caregivers for Seniors in Rural Areas

In this article, the demographic characteristics of family caregivers for seniors in rural communities are assessed to examine whether their circumstances could facilitate or impede their well-being. Services available in rural communities for family members providing ongoing care to frail seniors is examined, particularly those that provide health and social services. How families access these services and whether there are specific barriers in service provision are analyzed based on current social work practice and the research literature. Trends for future services are identified as well as whether these trends support new roles for social workers in rural settings.     

Shared Family Care: Fostering the Whole Family to Promote Safety and Stability

ABSTRACT

Shared Family Care is an innovative child welfare service that temporarily places whole families in the homes of community mentors who, along with a team of professionals, help the families to obtain the skills and resources they need to move toward self-sufficiency and adequately care for their children. This article provides an overview of this model, identifies existing programs in the United States, discusses key elements of the model, summarizes outcomes and comparative cost information, identifies implementation challenges, and provides tips for starting a Shared Family Care program in any community.     

Sexual Abuse Prevention: A Training Program for Developmental Disabilities Service Providers

Persons with developmental disabilities are at an increased risk for becoming victims of sexual abuse. Research has revealed that the largest group of identified perpetrators of sexual abuse is developmental disability service providers. The purpose of the present study was to develop, implement, and evaluate the effectiveness of a sexual abuse prevention training program. Participants were administered a survey assessing knowledge and attitudes before and after the training workshop. Small improvements in knowledge and attitudes about sexual abuse and the sexuality of persons with developmental disabilities were found; however, ge-neral attitudes about individuals with developmental disabilities did not change. Suggestions for future directions in this area are provided.     

Assessing Service Providers at LGBTQ-Affirming Community Agencies on Their Perceptions of Training Needs and Barriers to Service

Service providers (N = 109) at lesbian, gay, bisexual, transgender, and questioning (LGBTQ)-affirming social service agencies were surveyed on their perceived training needs, experiences, and barriers to service access experienced by their clients. Hierarchical regression analysis identified that training experiences significantly influenced self-perceived competence, controlling for agency-related factors including the extent of perceived barriers to service. Findings are discussed with implications for training, practice, and future research.     

Adolescents' Self-Reported Risk Factors and Desire to Talk About Family and Friends

Summary

Adolescents entering an urban mental health program completed Adquest, an 80-item self-report inventory asking about important areas in their life such as school and education, work, health, sexuality, substance abuse, personal and family life. This article examines how much adolescents wanted to talk about family and friends with their counselors, gender and age differences in this desire, and how that is mediated by behavioral risk factors. Irrespective of the existence of coping problems and behavioral risks, adolescents expressed a strong desire to discuss family, and, to a lesser extent, friends, in counseling. From a clinical standpoint, this finding highlights Adquest's limitations because it is based on an individual, behavioral risk paradigm rather than on more systemic factors in the lives of these adolescents. Implications regarding the use of practice-based research to facilitate reflective practice are discussed.     

浅析廊坊市社区居家养老服务体系的构建

廊坊市老龄人口总数和年增长率均高于全国平均水平,已提前进入老龄化社会,养老服务问题愈加凸显,加快养老服务体系建设至关重要。社区居家养老服务模式集合了家庭养老和机构养老的优点,以其人性化、便捷性、操作性强等独特优势,已成为全世界非常推崇的养老服务模式。通过纵向数据分析和横向比较分析,描述廊坊市人口老龄化的基本态势,深入剖析居家养老服务模式的内涵,并在探讨廊坊市居家养老服务的实践与存在的不足的基础上,提出构建社区居家养老服务体系的对策。     

Mothers of Children With Physical Disabilities: Influence of Family Processes on Mothers' Depressive Symptomatology

This study examines how family processes, or specific behaviors and relationships within the family, influence the risk of depression in mothers of children with disabilities. Specifically, the collective influence of children's maladaptive behavior problems, father involvement, and coparental conflict on the risk of depression among 60 married mothers of children with physical disabilities is examined. Based on data from the National Survey of Families and Households, findings showed that these mothers perceived the child's behavioral problems as less influential when they were more satisfied with the father's parenting. Furthermore, coparental conflict appeared to mediate the influence of the child's behavior and her satisfaction with the father's involvement on the mother's risk of depression.     

Family characteristics as predictors of intensity in family services

This article investigates factors influencing the number of hours families are involved with family services and uses these factors to develop a predictive model. This research began with focus groups involving family service workers who identified three key domains influencing service intensity: worker/family relationship, family motivation, and family characteristics. The family characteristics domain is the focus of this article. Influencing factors within this domain are examined through analysis of database information from 258 families who had previously accessed family services through a community services organization. Key predictors identified include the gender of main consumer, family size, and presence of issues such as family violence and physical illness. These findings are used to develop a model to predict intervention intensity for families accessing family services. The ability to estimate service intensity provides data to effectively develop innovative programs and enable better balancing of staff workloads and resources. Additionally, the capability to predict intensity helps allocate families to appropriate workers and programs.     

Internet-Based Clinical Services: Virtual Support Groups for Family Caregivers

ABSTRACT

Objectives: An internet-based psychotherapeutic support group intervention for family caregivers of persons with neurodegenerative diseases was developed in a series of pilot studies and subsequently evaluated in a feasibility study with 34 participants. The aim was to duplicate online group interactions typical of face-to-face support groups. Methods: A user-friendly web site was developed according to usability criteria for older adult users. Unique features of the web site included video conferencing in two formats, one-on-one and a group format with up to 6 participants and a facilitator. Following ten professionally facilitated sessions, each group evolved into a web-based self-help support group facilitated online by a group member. Results: Qualitative analyses of early, middle and late group video conferencing sessions yielded themes congruent with face-to-face group process. Follow up interviews six months following the initiation of the online groups showed overall positive participant responses in each of the following areas: learning to use computers, negotiating the web site links, obtaining disease-specific information from the website, using technology to communicate, bonding with group members, providing mutual guidance and support, and benefiting in terms of coping with the stresses of caregiving.     

城市社区居家养老服务的发展思路与对策

随着老龄化时代的到来,需要照料的失能、半失能、失独老人总量不断增加,在当前传统家庭的养老功能不断弱化、机构养老服务能力滞后的形势下,居家养老服务模式成为解决养老问题的重大战略抉择。但目前居家养老服务总体而言尚处于起步和试点示范阶段,在居家养老服务资源凝聚、开拓,居家养老服务运作和软硬环境营造等方面,面临不少问题和困境,建议从资金、人力、设施、运作环境等方面来解决居家养老服务的发展问题。     

Family support in late life: A review of the literature on aging,disability, and family caregiving

ABSTRACT

For older adults and people with disabilities in the United States, family caregiving is an important part of remaining at home and in the community. As care recipients and caregivers age, family dynamics change, and the health, social, and financial impacts of this (largely unremunerated) work have implications for individuals, families, and social policy. In this review, the authors map the literature across multiple fields related to disability and aging to understand caregiving in late life, what it means to be an older caregiver and/or to care for older people. The authors summarize the findings of 97 articles to address the care, services, and supports family caregivers provide for older adults; negative and positive impacts for caregivers serving in this role; supports that family members use or need; and societal impact of family caregiving. Much of the literature describes the work family caregivers provide and negative impacts of caregiving. Less attention is devoted to caregiving benefits, supports used by family caregivers, and societal impacts. The authors conclude with an agenda for future research that attends to the need for research that includes: more diverse samples, new types of caregivers, longitudinal data, qualitative data and analysis, and comparative research.     

Strengthening Families Through Volunteerism: Integrating Family Volunteerism and Family Life Education

This article builds on increasing interest in family volunteering by presenting it as a family life education tool for strengthening relationships and family functioning. In this context, family volunteering is similar to service learning in which families learn together while giving back to their community. Informed by a discussion on bioecological systems theory, psychosocial development theory, and select studies on volunteering, this article seeks to discover how family volunteering benefits individual and family growth. Existing research indicates that, due to its rich resources, it can deepen relationships, reinforce effective interpersonal skills, and help individuals overcome life's crises. Implications for family life educators and future research are presented, including the need for collaboration and stronger data on which to base flexible and fun volunteer opportunities for families.     

Family health care decision making

How do families choose a health plan when offered the option of insurance or a Health Maintenance Organization (HMO)? Choices are influenced by health consumerism, decision variables, family health needs, family composition, family socioeconomic status, and knowledge about HMOs. Subjects in the research reported here chose insurance or one of four HMOs; control subjects had no HMOs available. The model is estimated with LOGIT regression, yielding a pseudoR ² of.22 for the adjusted model. Participation in the decision process, number of chronic illnesses, and knowledge about HMOs all are significantly and positively associated with choosing an HMO; also, young adults are more likely than older adults to choose HMOs. The consumerism variable fails to attain significance. LOGIT analysis of the adjusted model indicates that the model predicted 72% of plan choices correctly. Suggested research for other family forms, for the poor, and for the elderly's health plan choices are discussed.     

Family networks in Andalusia,Spain

Family networks are a key resource for care in Spain, but this does not mean that they are explained by tradition or ideology. In fact, they are playing an important role in family change towards the dual-earner model supporting the involvement of mothers in paid work. The article analyses the structure of individuals' family networks as circles of non-cohabitant relatives which are kept active by relations, expectations, and mutual services. The information is based on the Family Networks Survey of Andalusia done in 2005 in this Spanish region to a wide sample of 10,000 interviewees.     

Formal and Informal Community Care to Older Adults: Comparative Analysis of the United States and Great Britain

Support to frail elders is of international and growing importance. This article compared receipt of assistance with ADL limitations, home health help, any assistance received, and unmet needs in functionally impaired individuals aged 70 years old or older in the United States (n = 1847, 80% women, M _age = 80 years) and Great Britain (n = 1203, 57% women, M _age = 78 years). Informal and formal assistance levels were higher in Great Britain, and rates of unmet need did not differ across ADL domains measured. Receipt of formal and informal care were associated positively, which is consistent with both supplementary and complementary perspectives on the formal-informal care interface. Few individuals in either country received formal services alone. Results suggest that community-based formal support does not substitute for family help. Implications for family and economic policy are discussed.     

Integrating Family Resilience and Family Stress Theory

The construct, family resilience, has been defined and applied very differently by those who are primarily clinical practitioners and those who are primarily researchers in the family field. In thisarticle, the family resilience perspective is integrated with conceptual definitions from family stress theory using the Family Adjustment and Adaptation Response (FAAR) Model in an effort to clarify distinctions between family resiliency as capacity and family resilience as a process. The family resilience process is discussed in terms of (a) the meaning of significant risk exposure (vs. the normal challenges of family life) and (b) the importance of making conceptual and operational distinctions between family system outcomes and family protective processes. Recommendations for future family resilience research are discussed.