Paid personal assistance services:an exploratory study of working-age consumers' perspectives

This study examined the experiences of individuals who use paid personal assistance services (PAS). Structured interview data were collected from a convenience sample of 24 working-age individuals from diverse backgrounds recruited from Centers for Independent Living in nine states. Respondents described their general satisfaction with current paid PAS, but many reported previous experiences with poor care related to the low wages, lack of training of PAS providers, and an inadequate supply of providers. Respondents reported many unmet needs because of a shortage of hours provided by state programs and the lack of help with daily living activities, transportation, childcare, and social activities. The respondents strongly preferred consumer-directed care.     

Using evaluation to improve program quality based on the BELL model

Building Educated Leaders for Life (BELL) is a national not-for-profit organization whose mission is to increase the educational achievements, self-esteem, and life opportunities of elementary school children living in low-income urban communities. BELL has been engaged in formal evaluation, internally and externally, for more than five years and has built internal evaluation capacity by investing in a specialized full-time evaluation team. As part of a continuous program improvement model of evaluation, BELL uses the data to refine program implementation and replicate successful elements of the services and operations. In this chapter, the authors highlight best practices from the field by outlining BELL's approach to using evaluation data for continuous program improvement. Key strategies include (1) carefully identifying intended users of the evaluation throughout the organization and among its external stakeholders, then working closely with intended users throughout the evaluation process, ensuring full engagement at every step of the process; (2) reporting findings in a readable, user-friendly format and timing the reporting so that it is aligned with programmatic decision making and planning cycles; and (3) making and supporting explicit recommendations for the next program cycle, where intended users have agreed to recommendations and ownership is assigned. BELL's successful use of data for improvement is evidenced by the consistently strong outcomes for the students it serves as well as increased efficiency and satisfaction related to service delivery that has supported the replication of BELL's programs nationally.     

Migration and retirement in the life course: an event history approach

Migration at older ages is commonly explained by reference to the search for greater amenity, and subsequently by the onset of greater dependency, but the links between mobility and specific life course transitions have rarely been articulated. We aim to establish the timing of migration in relation to retirement from the labour force, and to determine how its intensity varies around the retirement event. We also seek to identify how household and individual characteristics shape the propensity and timing of migration, differentiating moves according to distance and with particular attention to the characteristics of the spouse. Data are drawn from the first six waves of the Household, Income and Labour Dynamics in Australia survey, a nationally representative panel study covering the period 2001–2006. Migration events are identified relative to retirement and event history methods are employed to establish the characteristics predisposing households to relocate around retirement. Results demonstrate that retirement acts as a trigger to migration but the propensity to move falls as retirement age rises and the hazard is increasingly concentrated in the year retirement occurs. Within this framework the presence, health, education and retirement status of a spouse exert a significant influence on the likelihood of migration, though with different effects for long and short distance moves. Results highlight the importance of variations in underlying life-course trajectories in shaping retirement migration and demonstrate that only a minority of moves at ages 55–69 are directly associated with retirement, underlining the need for caution when identifying retirement migration using age as a proxy measure.     

Climate-related migration in rural Bangladesh: a behavioural model

Research into the climate change and migration nexus has often focussed solely on how people move in response to the impacts of variability and change in climate. This notion often ignores the nature of migration as a tried and tested livelihood choice amid a variety of socio-economic and environmental opportunities and limitations. This paper closely looks at the behavioural aspects of migration decision-making in Bangladesh in the context of changes in its economy, and, increasingly, exposure to the impacts of climate variability and change. We find that villagers in areas particularly affected by increasing climatic stresses and shocks are diversifying their traditional livelihood strategies by migrating. Environmental factors, including climatic stresses and shocks, often make such shifts even more necessary. Although the migrants’ primary motivation is better income, in effect, migration becomes an effective form of adaptation. Based on a qualitative study in three geographically distinct places of Bangladesh, we propose that migration is a socially acceptable behaviour that occurs in the context of perceived environmental change and climate variability. Migration decisions are mediated by a set of ‘behavioural factors’ that assesses the efficacy of different responses to opportunities and challenges, their socio-cultural acceptance and the ability to respond successfully. This understanding has policy relevance for climate change adaptation, in terms of both how migrants are perceived and how their movements are planned for.     

Trends in Functional and Activity Limitations among Chinese Oldest‐Old, 1998 to 2008

China has the world's largest oldest‐old population, but information on trends in late‐life disability is lacking. We use data from the Chinese Longitudinal Healthy Longevity Survey for 1998 to 2008 to determine whether prevalence of limitations with physical functions and daily activities has changed recently among the Chinese population aged 80 to 105 and, if so, to investigate the factors associated with the change. We find that prevalence of need for assistance with activities of daily living and inability to independently conduct instrumental activities of daily living declined substantially. Males did not experience improvement in ability to carry out underlying physical functions over the same period, but females did. Variables associated with trends in one or more of these outcomes were adequacy of medical care as a child, childhood hunger, father's occupation in agriculture, main occupation before age 60 in agriculture, adequacy of current medical care, and body weight.     

Educational success for children in public care: advice from a group of high achievers

ABSTRACT Research over the past 20 years has consistently shown that children in public care fall behind at school, seldom achieve good qualifications, and are much less likely than their peers to go on to further or higher education. However, a small minority of looked‐after children do well academically. This paper examines the opinions of 38 high‐achieving young people who spent at least a year in residential or foster care on what they think are the best ways to enhance the educational experience of looked‐after children. An evaluation of four key questions from a semistructured interview highlighted the importance of foster carers, residential workers, social workers and teachers in providing support and encouragement for academic achievement. On the other hand, many of these individuals emphasized their dislike of being ‘singled out’ by the teacher. A third of the participants believed that negative stereotypes and low expectations of children in care among professionals and care providers were major obstacles to their educational success. Over half the sample reported that in many children’s homes basic necessities such as books, a desk and a quiet place to do homework were lacking. In addition their opportunity to engage in outside interests and hobbies was severely limited. By contrast, for these individuals foster care had provided better opportunities. On entering higher education the majority of the participants had faced severe problems. They stressed the need for continuing financial support and adequate year‐round accommodation, because, unlike most students, these care leavers usually have no parental home to return to during university vacations. A third of participants also felt a strong desire for a ‘guardian angel’ to support and encourage them during their time at university. The paper concludes that the views of these thoughtful and resilient individuals should be taken very seriously and translated into improvements in policy and practice. Official guidance now highlights the importance of education for looked‐after children, but changing attitudes and priorities at ground level presents a major challenge.     

Atypical Working Hours: Consequences for Childcare Arrangements

This paper analyses the care arrangements of those dual‐earner couples and lone‐parent families who are under strong pressure because of atypical and unpredictable working hours. In these situations, the parents have to invent day‐to‐day, week‐to‐week solutions for the care needs of their children, mobilizing all available formal and informal resources. The objective is to understand the different ways in which families manage such atypical working hours in three different countries (Finland, France and Portugal). What are the main strategies of the parents in facing this pressure? Do these include negotiations between the parents on the division of tasks, mobilization of ex‐partners, grandparents, brothers and sisters, neighbours, and the different solutions offered by the formal resources? In the first part of the paper, we present the challenges and consequences of atypical working hours for families and institutions in Europe, in particular in Finland, France and Portugal. We then analyse some of the childcare arrangements as well as the impact of the provision of childcare services.     

Judged knowledge and ambiguity aversion

Competence has recently been proposed as an explanation for the degree of ambiguity aversion. Using general knowledge questions we presented subjects with simple lotteries in which they could bet on an event and against the same event. We show that the sum of certainty equivalents for both bets depends on the judged knowledge of the class of events. We also elicited the decision weights for events and complementary events. We found a similar effect of knowledge on the sum of decision weights.