Outsourcing within the Nordic context: Care services for older people in Finland

The early 1990s economic setback brought significant reforms favoring the outsourcing of care in Finnish municipalities. Here, outsourcing refers to the practice of municipalities employing private organizations through different means (e.g., open tendering) to deliver public care services. In this context, this study examines the growth in the outsourcing of service housing and home-help services in 311 municipalities from 2001 to 2015 and investigates the municipal factors associated with outsourcing using four dimensions: care needs, population size, economic situation, and political ideology of the municipality. The findings reveal a steep increase in the outsourcing of home-help and service housing. Care needs of older people are the most influential factor for outsourcing, particularly for service housing. Overall, the findings show a growing trend in private care provision in Finnish municipalities.     

Translating case management in a service for older people in Berlin

Case management is a coordinating process designed to align service provision more closely to the identified needs of people requiring assistance in the context of complex care systems. It is an approach that has crossed the borders of different national welfare systems where it has been adopted to address ostensibly similar problems. This empirically based but primarily methodological article draws on the author's doctoral research during which he spent an extended period in Berlin investigating a citywide case management service for older people in the context of German long-term care policy and legislation. It explores the extent to which a specific case study can illuminate how case management adapts in differing national welfare systems and highlights the particular methodological challenges of ‘translation’ and ‘equivalence’ in cross-national research. The article outlines how institutional context both shaped and constrained the Berlin case management service and highlights the necessity in cross-country research for a critical contextual examination of apparently similar features. This is particularly relevant where English words and expressions are directly absorbed into the local language, an important yet rarely addressed complicating factor.     

Attitudes of social work students towards older people

Demographic ageing is a challenge for many countries. Even though Turkey has a relatively younger demographic composition, the proportion of the older people (65+) within the population is rapidly increasing. Within this framework, older people are becoming more important clients for both social work students and social workers in Turkey. This study aims to reveal the attitudes of social work students towards older people and determine the various factors that affect their views on older persons. In the scope of the project, Kogan's Attitude Towards Old People Scale was applied to 419 social work undergraduate students at a university located in Central Anatolia. The findings showed that social work students scored a mean of 130.96 and they generally had positive attitudes towards older people. The correlation between year of study, gender and age was not statistically significant. However, having lived mostly in urban areas was positively correlated with the mean Kogan scores and this finding was found to be statistically significant. Exposure to personal contact with older people at both the personal and professional levels was influential in shaping attitudes about the older people.     

Family income and attitudes toward older people in China: comparison of two age cohorts

Three hundred and five traditional college students and 159 baby boomers (40–55 years old) in China participated in the study with Kogan’s Attitude toward Old People [Kogan (1961) Journal of Abnormal and Social Psychology, 62(1), 44–54] being used. Results from ANOVA showed overall, baby boomers held more positive attitudes toward older people than college students. There was a significant interaction effect between cohorts and family income; that is, the lower family income group in both samples did not differ significantly from each other, it was in the higher family income group that difference was revealed. Baby Boomers in the higher family income group held more positive attitudes toward older people than students in the same family income group. Gender was not a significant factor in either sample. Stepwise regression analyses revealed that family income was a significant predictor of attitude in the Baby Boomer sample, but not in the college student sample.     

Comparison of the characteristics of homes for older people in Slovenia with Goffman's concept of the total institution

The past concepts of life and work in homes for older people in Slovenia are no longer adequate to meet the needs, wishes and requirements of their current users. One of the basic premises, relying on Goffman's concept of the total institution, is that the first and foremost characteristic of homes for older people is that they are institutions. The theoretical starting point, namely that Goffman's concept of the total institution is ideal-typical, was corroborated by an investigation of the presence of elements of the total institution in Slovenian homes for older people, proving that not all features of the total institution can be found in any chosen empirical selection of institutions, with the data showing that those characteristics which are present do not exist in the ideal, that is in the most pronounced form. The homes’ users are given consideration, their personnel are adapting to their needs and requirements, even though this occurs within the functioning of an institution whose aims, i.e. to care for a large number of people living in one place, make life in such an institution subordinated to rules, along with the bureaucratisation and routinisation of services.     

The influence of the economic crisis on quality of care for older people: system readiness for innovation in Europe

The aim of this study is to examine the influence of the recent economic crisis on the quality of long-term care for older people in Belgium and the Netherlands. A mixed-method approach was applied, primarily focused on conducting semi-structured qualitative interviews with health professionals working in a management role in organizations providing long-term care for older people. The results show that Dutch organizations seem to be prepared for the influences of the economic crisis on the quality of its care provision primarily in terms of a sound system readiness. At the same time, Belgian organizations seem to be prepared for the influences of the economic crisis on the quality of its care provision primarily in terms of a favorable sociopolitical context. Comparing two countries allows for reciprocal lesson-drawing. The conclusion drawn in this study is that a sustainable long-term care system requires above all stability and structure.     

Intentions and strategies among elderly people: Coping in everyday life

Many studies of the elderly adopt a provider perspective, focusing on social policy, organizations, and professional groups. Less is known about how the elderly manage when they eventually need help in everyday living. This study examined the everyday behavior and strategies of the elderly through conducting semi-structured, in-depth interviews with 22 people over age 65. The intentions and strategies found revealed that the elderly managed or coped in active, adaptive, and passive ways, ranged along a continuum from actively maintaining their independence to passively depending on others.     

Learning with active rural community-dwelling older adults: comprehensive effects of intergenerational service-learning in Taiwan

This study evaluated the experiences of college students serving with active, rural community-dwelling older adults and evaluated outcomes among the students, older adults, and community leaders in rural Taiwan. Thirty-one undergraduate students assisted older adults for six weeks at three senior citizen centers as they participated in an active aging competition. The analysis of qualitative data indicated that students adapted to the communicating barriers of language and cultural variances, were aware that older adults longed for company, and impressed the active image of older adults. The results of this study indicated that service-learning with rural community-dwelling older adults simultaneously benefits students, community leaders, and older adults.     

Transitions to part-time work at older ages: the case of people with disabilities in Europe

This paper analyses the labour-force transitions of older workers with disabilities in general, particularly workers’ transitions to and from part-time employment within a European context. Using the two first waves (2004 and 2007) of the Survey of Health, Ageing and Retirement in Europe, we compare transitions between employment statuses for disabled and non-disabled individuals, even after controlling for different disability trajectories. In addition, we employ a multivariate framework to examine the determinants for remaining in part-time work in 2007 for those individuals who were part-timers in 2004. The results show that older people with long-term disabilities have a higher probability of staying in a part-time job than their compared counterparts. Policy-makers must promote part-time employment as a means of increasing employment opportunities for older workers with disabilities and support gradual retirement opportunities with flexible and reduced working hours.     

Speed Mentoring in Teaching and Learning: Young people with experience of the care system mentor social work students

The value of listening and talking to young people with experience of the care system has been recognised as a vital and positive contribution to social work students' learning. A model of co-production was used to develop a series of speed mentoring events whereby social work students placed in local authority children and family settings were mentored by young people with experience of the care system. This tentative review of this small-scale project shares the authors' critical reflections on the value and reliability of this model, for evaluating the outcomes of co-productive mentoring relationships between young people and social work students. The reversal of the power dynamic between student and service user contributed to the unsettling of assumptions about each other and empathy for each other's role. The student authors reflect on learning about the child's experience that has influenced their practice. The mentor authors welcomed the opportunity to participate in the development of ‘young people friendly’ social workers. Suggestions are made as to how this model could be developed to contribute to a more systematic approach to the role of service users in mentoring, advising and contributing to the supervision process of students and social workers.     

Promoting the mental well-being of older people from black and minority ethnic communities in United Kingdom rural areas: Findings from an interview study

Drawing from 81 interviews with practitioners in social care and housing with care services in the United Kingdom, this paper explores practice issues in rural areas when supporting the mental health and well-being of older people from Black and minority ethnic groups. The paper begins with a review of the literature which provides evidence that BME older people are likely to be increasingly part of the populations of rural areas. Next it presents interview data revealing that while practitioners are aware of such demographic changes in general terms; some feel that they lack training and skills in adapting their professional practice to support all older people. Others express feelings of professional isolation in seeking to support older people from minority groups and are concerned that older people from minority groups may be at risk of isolation and loneliness. The paper concludes with a discussion of the study's implications for rural practice, policy and research.     

Legislating for Filial Piety: An Indirect Approach to Promoting Family Support and Responsibility for Older People in Korea

Although every culture follows its own indigenous elder care practices, Korea has retained a unique way of supporting elder parents, specifically, and older people in general. When the care of older people in Korea became significantly challenging, it was determined to launch a controversial law to promote the tradition of filial piety. The main content of the law consists of requiring the government to take action to encourage filial piety and to support those adult children who care for their parents. Although this legislation has the potential to promote the practice of filial piety, the nature of the law is largely rhetorical and symbolic rather than practical, and as a result, its workability and efficiency are limited.     

Connected seniors: how older adults in East York exchange social support online and offline

ABSTRACT

How do older adults mobilize social support, with and without digital media? To investigate this, we focus on older adults 65+ residing in the Toronto locality of East York, using 42 interviews lasting about 90 minutes done in 2013–2014. We find that digital media help in mobilizing social support as well as maintaining and strengthening existing relationships with geographically near and distant contacts. This is especially important for those individuals (and their network members) who have limited mobility. Once older adults start using digital media, they become routinely incorporated into their lives, used in conjunction with the telephone to maintain existing relationships but not to develop new ones. Contradicting fears that digital media are inadequate for meaningful relational contact, we found that these older adults considered social support exchanged via digital media to be real support that cannot be dismissed as token. Older adults especially used and valued digital media for companionship. They also used them for coordination, maintaining ties, and casual conversations. Email was used more with friends than relatives; some Skype was used with close family ties. Our research suggests that policy efforts need to emphasize the strengthening of existing networks rather than the establishment of interventions that are outside of older adults’ existing ties. Our findings also show that learning how to master technology is in itself a form of social support that provides opportunities to strengthen the networks of older adults.     

Abuse and older lesbian,gay bisexual,and trans (LGBT) people: a commentary and research agenda

With increasing visibility of older lesbian, gay, bisexual and trans (LGBT) people, there is an urgent need to understand abuse in their lives. This is an under-researched area, which this scoping study (based on a literature review and a small subset of data taken from a larger project) serves to demonstrate. The content of this article formed the basis of a paper presented at a workshop on ‘LGBT Elder Abuse’ held at Keele University(UK) in 2017, convened and chaired by the author. It considers LGBT elder abuse in terms of polyvictimisation, intersectionality and the abuse of power. The identifies knowledge gaps, proposes a research agenda, and explains why such an agenda matters. In particular, the need for researchers of elder abuse, LGBT domestic abuse and organisational abuse to cut across their traditional boundaries of inquiry in order to address how the abuse of older LGBT people intersects with each domain     

Transport-related social exclusion amongst older people in rural Southwest England and Wales

Rural dwelling and older age are both associated with a higher risk of social exclusion, with accessibility identified as having an important facilitating role. The interactions between transport-related exclusion and older age, particularly in a rural context, are considered though analysis of quantitative and qualitative data collected from over 900 older persons living in rural areas of Southwest England and Wales. Although few respondents reported feeling excluded within their communities, more reported difficulties in accessing specific necessary and discretionary activities, including specialist hospitals and cinemas. Analysis revealed that car availability is not a strong indicator of overall inclusion, although non-availability was important in limiting access to particular types of location. It is concluded that the relatively short travel distances required to access community activities was a key factor in the high levels of community inclusion. However, the car-dependent nature of travel overall means that there is a rising risk of mobility-related exclusion in rural areas, particularly amongst the oldest old. Greater consideration needs to be given to more formalised lift-giving as a transport solution, along with greater attention to mobility needs by sector-specific service providers, such as the health sector.     

Korean immigrant older adults residing in Non-Korean ethnic enclaves: Acculturation strategies and psychosocial adaptation

ABSTRACT

Based on Berry’s bi-dimensional model of acculturation, this study examined acculturation strategies among first-generation Korean immigrant older adults residing in areas without a well-established Korean ethnic enclave and how their acculturation strategies are associated with psychosocial adaptation and acculturative stressors. Cluster analysis (N = 108) identified three acculturation strategies such as separated, moderately bicultural, and fully bicultural, indicating that the sample did not exhibit all four acculturation strategies of Berry’s model. The moderately bicultural group of the sample was the most dominant in size, which indicated strong adherence to Korean culture. The fully bicultural group reported less acculturative stress and depressive symptoms than the separated group, which indicated that biculturalism is strongly associated with a better psychosocial adaptation. A factor analysis showed that the separated group perceived stressors such as limited English proficiency and social isolation as more stressful than the other groups. The findings suggest that even though a strong adherence to ethnic culture might be a first-generation Korean immigrant older adults’ dominant acculturation strategy, it may make them more vulnerable to lingual and cultural barriers in a mono-cultural community without Korean ethnic enclaves. Implications for social work practice are explored.     

Identification and treatment of older persons with sarcopenia

Abstract

In the last decades, sarcopenia in older persons has been operationalized by the assessment of lean body mass, muscle strength and/or physical performance. Several definitions of sarcopenia, using different parameters and cut-offs, have been proposed. However, which is the best definition to describe and to assess this condition is still matter of debate. Hand grip strength has been suggested as better predictor of incident mobility impairment and mortality, than skeletal muscle mass. In the light of the current knowledge, we sought to propose an operative approach for identifying and treating sarcopenic older persons according to main categories of sarcopenia: the age-related or primary sarcopenia and disease-related or secondary sarcopenia. We suggest that a quantitative assessment of grip strength alone might be sufficient to identify patients with primary sarcopenia. When chronic diseases accompany the ageing process, the combined assessment of muscle strength plus a balance test could be more appropriate. The identification of tests and pathological relevant cut-offs that facilitates the entry of sarcopenia into the clinical practice, could step forward researchers and physicians. This could be important for planning multidisciplinary models to maximize the maintenance of locomotive abilities especially in older persons affected by chronic diseases such as Parkinson’s disease.     

The role of self-advocacy in work for people with learning difficulties

This paper explores the relationship between self-advocacy and work for people with learning difficulties [1]. Explorations are based mainly on a participant observation study in which members of a self-advocacy group for people with learning difficulties included the researcher in their regular meetings. Discussions about work, most broadly defined as meaningful activity which makes a contribution to society, emerged as a critical preoccupation. We examine the importance of self-advocacy as a vehicle for people with learning difficulties who want to remove or circumvent barriers which surround their employment. Our research shows that understanding the role of self-advocacy in relation to work creates many development opportunities for both disabled employees and their prospective, or actual, employers. It is suggested that self-advocates can themselves achieve change in employers' attitudes by challenging oppressive images of people with learning difficulties in the workplace. It is hoped the paper will advance recognition of the importance of self-advocacy for maximising the participation of people with learning difficulties in work, and for acceptance of their status as workers.     

A Hitchhiker's Guide to caring for an older person before and during coronavirus‐19

Coronavirus‐19 (COVID‐19) has reconfigured working lives with astonishing velocity. Older people have suffered the worst effects of the pandemic, with governments marginalizing or overlooking their needs. Women perform the majority of care for older people, often compromising their working lives and health. Yet in academic articles their voices are often filtered or aggregated in quantitative studies. Based on a weave of personal experiences and secondary research, the article traces a path through UK forms of care and shows how the inadequate response to COVID‐19 stemmed from existing policies embedded in health and social care. COVID‐19 has severed important informal care work, rendering the vulnerable yet more exposed and carers anxious and bereft. Longitudinal research capturing the trajectory of care from the perspective of older people and their carers would lead to improved support hence gender equality.