Means Testing and the Heterogeneity of Housing Assets: Funding Long-Term Care in Spain

The access to publicly funded long‐term care (LTC) in Spain has been traditionally rationed through the use of means tests based on individuals’ current income and needs. However, individuals’ wealth, primarily housing assets, is progressively taken into account. Parallel to this feature, the responsibilities for the organization of LTC services have been devolved to region‐states – autonomous communities (ACs), giving rise to some regional heterogeneity, though limited evidence has been reported on the underlying determinants. This paper examines the current role of housing assets in determining public and private funding for long‐term care in Spain. Secondly, we present a qualitative and quantitative examination of the regional heterogeneity in the provision and public funding criteria determining eligibility for public support for LTC. Finally, we report survey evidence on the individual's willingness to sell (WTS) their housing assets in order to either totally or partially finance the access to LTC. Our findings suggest that housing assets are the main source of wealth accumulation at old age. Yet there is significant regional heterogeneity in the access to LTC resulting from regional differences in the means testing criteria. Progressively, all ACs are considering housing assets in their means testing criteria. Interestingly, individuals’ willingness to sell their housing assets declines with age and is more common among less skilled and widowed individuals.     

It takes a Village: community practice, social work, and aging-in-place

The US population of older adults will increase significantly in the coming decades. Most of these individuals prefer to age in their homes/communities. However, most communities are not prepared to handle the long-term care needs of an aging population. This article examines one model that communities are using to help older adults age-in-place, the Village. A conceptual lens based in community practice and empowerment theory is offered to explicate this model and critically evaluate social work's role in it. It also presents challenges to social work roles in facilitation and evaluation of the model.     

Integrating mental health parity for homebound older adults under the medicare home health care benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.     

Conflict Outcome as a Function of Parental Accuracy in Perceiving Child Cognitions and Affect.

It is usually maintained that positive family functioning and internalization of parental values are promoted by parents' consistent use of particular discipline strategies or styles of childrearing. In this paper a different position is presented, viz., that parents who can accurately perceive their children's thoughts and feelings during a disagreement will have the most successful outcomes because they can tailor their disciplinary interventions to the particular states of their children at the time. Adolescents and their parents were interviewed about recent disagreements and asked to rate themselves and their partner on measures of anger, blame, acceptability of their own and their partner's behavior, and satisfaction. In families where fathers were accurate in their perceptions of their adolescent's cognitions and affect there were fewer conflicts per week. Accurate perception on the mothers' parts was related to their satisfaction with the outcomes of the disagreements. There was no relation between adolescents' perceptual accuracy and number of conflicts or their satisfaction with the outcomes.     

Design limitations of long-term care insurance schemes: A comparative study of the situation in Spain

Social and demographic changes are gradually transforming the way Western societies cope with old‐age dependency, in particular the provision of long‐term care (LTC). In response to the need for formal care services and financing instruments, this study examines a range of both private and public insurance tools. As a general rule, LTC insurance is markedly underdeveloped. Furthermore, in southern European countries, the role of the public sector in LTC is unclear compared with its role in other, related welfare areas such as healthcare. The study examines the financing alternatives for LTC insurance, taking as its benchmark the Spanish LTC financing reform. It briefly examines some existing, publicly funded LTC financing tools and explores the potential role of private LTC insurance, arguing that it has an active part to play alongside compulsory mainstream insurance schemes and self‐insurance alternatives. As in other European countries, Spanish social attitudes show a preference for some kind of general entitlement to publicly funded schemes, although this preference is subject to significant regional heterogeneity.     

Sexual functioning and practices in a multi‐ethnic study of midlife women: Baseline results from swan

This study examined the sexual practices and function of midlife women by ethnicity (African American, Caucasian, Chinese, Hispanic, Japanese) and menopausal status. Sexual behavior was compared in 3,262 women in the baseline cohort of SWAN. Participants were 42 to 52 years old, premenopausal or early perimenopausal, and not hysterectomized or using hormones. Analysis used multivariate proportional odds regression. In our sample, 79% had engaged in sex with a partner in the last 6 months, and a third considered sex to be very important. Common reasons for no sex (n = 676) were lack of partner (67%), lack of interest (33%), and fatigue (16%). Compared with Caucasians, Japanese and Chinese women were less likely, and African Americans more likely, to report sex as very important (p < 0.005). Significant ethnic differences were found for frequency of all practices. Perimenopause status was associated only with higher frequencies of masturbation and pain during intercourse.     

Changes in Admissions Work Arising from the New Social Work Degree in England

The business of admissions to higher education in England is a significant task for academic and support staff. This paper draws on the Evaluation of the New Social Work Degree Qualification in England (2004–2008) to describe the changes in admissions work for social work staff in higher education associated with the change from diploma to a degree level qualification for entry to the profession; to report how staff involved in admissions work are managing these changes; and to identify elements of admissions processes that are perceived to be fulfilling the new requirements of the degree and those which are identified as more problematic. The article draws on two telephone/email surveys of a national sample of social work programmes and on face-to-face in-depth interviews with a sample of teaching staff from nine social work programmes in six higher education institutions undertaken during 2005–2007. The work of admissions staff is rarely scrutinised in studies of higher education or specifically in social work programmes: this article discusses the spectrum of approaches. It recommends monitoring of the outcomes of practices in admissions work that are recasting Department of Health Requirements as the minimum.     

Schizophrenia Fellowship of Australia,Inc.

One of the most stigmatized health areas is mental health, so the feasibility of a self-help organization to assist those with the common mental illness, schizophrenia, was contemplated with some misgivings by the Victorian Mental Health Authority in 1977. However, as it was departmental policy to encourage community involvement in alleviating mental illness and its associated problems, a number of relatives of people with schizophrenia were contacted to assess their reaction to the proposition. The response was positive and eight relatives agreed to become a steering committee to organize a public meeting to put forward the idea of forming a self-help organization centred on schizophrenia.     

“Capacity Is Key”: Investigating New Legal Provisions in England and Wales for Adult Safeguarding

This study aimed to investigate the views and experiences of local Safeguarding Adults Coordinators of the newly implemented Mental Capacity Act 2005. This legislation in England and Wales has both protection and empowerment as its dual goals. Fifteen Safeguarding Adults Coordinators (SACs) employed by local authorities in the London area were interviewed in 2008, and again 2 years later. A total of 12 SACs participated in the 2010 follow-up interviews. The findings are reported here, covering experiences and views on the implementation and uses of the Act. There was overwhelming support for the Act as enhancing people's rights to a life free from abuse, of providing a framework for the assessment of decision-making capacity, and of assisting practitioners in reducing risks and responding to abusive situations. Participants urged better publicity about the Act, more detailed guidance on the new offenses, and greater attention to the interactions with other government policy goals.     

Lack of reciprocity among Dutch teachers: Validation of reciprocity indices and their relation to stress and well-being

This research presents the results of two related studies on the convergent and construct validity of three measures of reciprocity in exchange relationships at work. In Study 1, 71 Dutch teachers were interviewed about their specific investments and outcomes in the exchange relationships with their students, colleagues and school. ANOVA revealed that they reported significantly more investments than outcomes, and that the number of reported investments and outcomes mentioned varied as a function of the type of exchange relationship. Building on these results, multi-item scales were created to assess reciprocity at a detailed level for each of the three exchange relationships. Study 2 validated these specific reciprocity measures by relating them to two global assessments of reciprocity (convergent validity) as well as to measures of job stress and well-being (construct validity). LISREL-analysis of data obtained from a further sample of 224 teachers revealed that for each type of exchange relationship there were significant, consistent and meaningful relationships among the three reciprocity measures. Further, hierarchical regression analysis showed that the reciprocity measures were differentially related to job stressors and measures of well-being. Implications are discussed.