Loss and grief: The experience of transition to residential aged care

There is growing recognition of the experience of non-death-related loss and grief. One unexplored area of non-death-related loss and grief is associated with older people’s transition from home to residential aged care (RAC). This paper reports findings from a qualitative study that explored the experiences of people living in RAC, carer-relatives of people living in RAC and RAC staff. Using theories of loss and grief, the paper identifies features of the transition to RAC that are associated with unresolved loss and maladaptation to changed circumstances, and the types of support that would mitigate these. Using a series of focus groups with both residents and carer-relatives, as well as staff, the study found that residents and their families need more support to negotiate the multiple, often necessarily hasty decisions and bureaucratic requirements associated with transitioning to RAC, while simultaneously experiencing loss and grief. The types of support that families would welcome from service providers include facilitating shared decision making, valuing family and community carer expertise and providing practical information and assistance to fulfil administrative obligations.     

Supporting foster and kinship carers to promote the mental health of children

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care.     

Using relative utility curves to evaluate risk prediction

Summary.  Because many medical decisions are based on risk prediction models that are constructed from medical history and results of tests, the evaluation of these prediction models is important. This paper makes five contributions to this evaluation: the relative utility curve which gauges the potential for better prediction in terms of utilities, without the need for a reference level for one utility, while providing a sensitivity analysis for misspecification of utilities, the relevant region, which is the set of values of prediction performance that are consistent with the recommended treatment status in the absence of prediction, the test threshold, which is the minimum number of tests that would be traded for a true positive prediction in order for the expected utility to be non-negative, the evaluation of two-stage predictions that reduce test costs and connections between various measures of performance of prediction. An application involving the risk of cardiovascular disease is discussed.     

Communication in assisted living

This study of communication in an Assisted Living Facility (ALF) focuses on staff's interpretive frameworks and situational tactics for managing elderly residents. It is based on interviews with staff and residents in an ALF together with ethnographic fieldwork. As in other quasi-total institutions, staff members engage in control as well as care, monitoring residents for compliance with rules and directives. Residents, aware of the threat of being moved to a nursing home, also monitor their own behavior and cognition in comparison to other residents. Other communication issues include the infantilization of the elderly by staff, and the race, class, and ethnic prejudices of residents.     

‘Now I’d like to sleep with Rachael’ – researching sexuality support in a service agency group home

Many intellectually disabled people living in agency services require significant forms of support to live safe and satisfying sexual lives. Research reveals that despite support personnel working in service systems now holding largely positive attitudes towards sexuality assistance, proactive practice is rarely initiated. This article probes what might lie within this attitude/assistance gap. This investigation reveals a complex picture of practices that rely on intellectually disabled people showing conformation to a ‘couple doing normal’ ideal, so as to be judged capable of being supported. It examines how wider social locations of meaning related to ‘intellectual disability’ and ‘sexuality’ might substantiate these judgement calls. The degree to which it can be said that worker’s own attitudes and values underpin their reluctance to provide support is then explored. Finally, why researchers and practitioners might need to reappraise the complex interactions that shape worker’s practice in this area is discussed.     

Doin’ Meth or Doin’ Math: What Client Constructions of Social Class Mean for Social Work Practice

The voices of people experiencing poverty are underrepresented in social work research, public policy development, and practice interventions. This study explored the social class attributions of clients receiving poverty-related services through qualitative interviews. Findings reveal dynamic contributions of individual, environmental, and structural factors of social class positioning and significant stress and stigmatization associated with experiencing economic hardship. Participants indicate a sense of lived contradiction, viewing social class to be the result of fate while simultaneously endorsing individualistic attributions of poverty. Results have implications for social work research and practice, as well as poverty-related policy and program development.     

The politics of leisure and labor mobilities: discourses of tourism and transnational migration in Central Java,Indonesia

This article presents narratives and tropes of transnational tourism from a less considered perspective: rural migrant-origin villagers of Central Java. Drawing from ethnographic fieldwork conducted in Cilacap and Yogyakarta, I analyze how and why some former temporary labor migrants depict their typically harsh experiences in terms of tourism and leisure. Addressing the tendency in current research to approach labor migration and tourism as mutually exclusive or unrelated class categories and experiences, I consider the ways in which former migrants and non-migrant villagers evaluate or identify labor migration in terms of gender, class, religious, and ethno-national subjectivities associated with ‘tourist’ and/or ‘migrant’ categories. Popular and commercial imaginations of leisure travel and tourism importantly shape the subjectivities and positionalities of precarious labor migrants. Foregrounding the relations between tourism and labor migration reveals the multi-scalar ways in which associated discourses and infrastructures of both mutually shape and constitute global socio-economic inequalities.